Anemia in Children
Anemia is a common problem in
children. About 20% of children in the U.S. will be diagnosed with anemia at some
A child who has anemia doesn't have enough red blood cells or hemoglobin. Hemoglobin
a type of protein that allows red blood cells to carry oxygen to other cells in the
There are many types of anemia.
Your child may have 1 of these:
Iron deficiency anemia.This is when the child doesn't have enough iron in the blood. Iron is needed to
form hemoglobin. This is the most common cause of anemia.
Megaloblastic anemia.This is when red blood cells are too large from a lack of folic acid or vitamin
B-12. One type of megaloblastic anemia is pernicious anemia. In this type, there is
problem absorbing vitamin B-12, important to making red blood cells.
Hemolytic anemia.This is when red blood cells are destroyed. There are many different causes,
such as serious infections or certain medicines.
Sickle cell anemia.This is a type of hemoglobinopathy, an inherited type of anemia with abnormally
shaped red blood cells.
This is another inherited type of anemia with abnormal
red blood cells.
Aplastic anemia.This is failure of the bone marrow to make blood cells.
Anemia has 3 main causes:
- Loss of red blood cells
- Inability to make enough red blood cells
- Destruction of red blood cells
Decreased red blood cells or hemoglobin levels may be due to:
- Inherited red blood cell defects
- Some diseases
- Certain medicines
- Lack of some vitamins or minerals in the diet
Risk factors for anemia include:
- Premature or low birth weight
- Living in poverty or immigrating from developing country
- Too much cow’s milk
- Diet low in iron, or some vitamins or minerals
- Surgery or accident with blood loss
- Long-term illnesses, such as infections, or kidney or liver disease
- Family history of an inherited type of anemia, such as sickle cell anemia
Most symptoms of anemia are due to
the lack of oxygen in the cells. Many of the symptoms don't occur with mild anemia.
These are the most common
- Increased heart rate
- Breathlessness, or trouble catching a
- Lack of energy, or tiring easily
- Dizziness, or vertigo, especially when
- Irregular menstrual cycles
- Absent or delayed menstruation
- Sore or swollen tongue
- Pale skin
- Yellowing of skin, eyes, and mouth
- Enlarged spleen or liver
- Slow or delayed growth and
- Poor wound and tissue healing
Many of these symptoms may be
caused by other blood problems or health conditions. Anemia is often a symptom of
another disease. Report any symptoms to your child’s healthcare provider. Always see
your child's provider for a diagnosis.
Because anemia is common in
children, healthcare providers do routine screening for it. Plus, it often has no
symptoms. Most anemia in children is diagnosed with these blood tests:
This is often the first screening test for anemia in
children. It measures the amount of hemoglobin and red blood cells in the blood.
Complete blood count (CBC).A complete blood count checks the red and white blood cells, blood-clotting
cells (platelets), and sometimes young red blood cells (reticulocytes). It includes
hemoglobin and hematocrit and more details about the red blood cells.
Peripheral smear.A small sample of blood is checked under a microscope to see if the blood cells
To get a blood sample, a healthcare
provider will insert a needle into a vein, often in the child's arm or hand. A
tourniquet may be wrapped around the child's arm to help the healthcare provider find
vein. Blood is drawn up into a syringe or a test tube. In some cases, blood can be
using a needle prick.
Blood tests may cause a little
discomfort while the needle is inserted. It may cause some bruising or swelling. After
the blood is removed, the healthcare provider will remove the tourniquet, put pressure
on the area, and put on a bandage.
Depending on the blood test
results, your child may also have a bone marrow aspiration, biopsy, or both. This
done by taking a small amount of bone marrow fluid (aspiration) or solid bone marrow
tissue (core biopsy). The fluid or tissue is checked for the number, size, and maturity
of blood cells or abnormal cells.
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.
The treatment for anemia depends on
the cause. Some types don't need treatment. Other types may require medicine, blood
transfusions, surgery, or stem cell transplants. Your child's healthcare provider
refer you to a hematologist. This is a specialist in treating blood
disorders. Treatment may include:
- Vitamin and mineral drops or
- Changing your child's diet
- Stopping a medicine that causes
- Blood transfusions
- Stem cell transplants
- Surgery to remove the spleen (very rare)
The complications of anemia depend
on what is causing it. Some types have few complications. But others have frequent
serious complications. Some anemias may cause:
- Problems with growth and development
- Joint pain and swelling
- Bone marrow failure
- Leukemia or other cancers
Some types of anemia are inherited
and can’t be prevented. Iron deficiency anemia, a common form of anemia, may be
prevented by making sure your child gets enough iron in their diet. To do this:
Breastfeed your baby if
They will get enough iron from your breastmilk.
Give formula with iron. If
your child is on formula, use formula with added iron.
Don't give cow’s milk until after
Cow’s milk doesn't have enough iron. It should not be given to babies
until after they are 1 year old, when they are eating enough other food. Too much
cow's milk also prevents the body from absorbing iron. Iron is needed to make new
Feed your child iron-rich
When your child eats solid foods, choose foods that are good sources of
iron. These include iron-enriched grains and cereals, egg yolks, red meats, potatoes,
tomatoes, and raisins.
When to Call a Healthcare Provider
Call your child's healthcare provider if you notice that your child
has any of the symptoms of anemia. And if your child hasn't been checked for anemia,
talk with the provider about your child's risk of getting it.
- Anemia is a low red blood cell count
or a low hemoglobin level. It's a common problem in children.
- There are many different types of
- Risk factors for children include being premature, living in
poverty, having too much cow's milk, a diet low in iron, and certain long-term
- Mild cases often have no symptoms. But
common symptoms include fast heart rate, breathlessness, lack of energy, dizziness,
headache, and irritability.
- The treatment of anemia depends on
what is causing it.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.