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It will take many cycles before the birth control will settle and her periods will regulate. Often the GYN will give a prescription for a continuous dose of meds so the periods stop altogether. (I'm on continuous BCPs so I no longer get any periods but it took almost 4 months before the spotting and cycles ceased completely) The IV iron does not work immediately. It takes time for your body to use the iron to help make the blood cells. If she's still losing blood her baody has yet to have an opportunity to catch up. Blood transfusions are an immediate fix as your blood supply is replenished. The iron is adding the missing ingredient in the recipe for making red blood cells. Your body still has to then manufacture them. There are MANY reasons for anemia and your neice could well be suffering from more than one cause. The dr will first address the obvious (her periods) and go from there. Anemia usually develops over a long period of time and takes a while to resolve. As for the chewing washcloths--many suffering from vitamin/mineral deficiencies crave odd non food items. Many crunch ice obsessively. This may well be a part of that. It's called "pica." It may resolve itself when the anemia begins to abate.

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