Anemia in Children

What is 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 point.
A child who has anemia does not have enough red blood cells or hemoglobin. Hemoglobin is
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 not 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 a problem absorbing vitamin B-12, important to
    making red blood cells.
  • Hemolytic
    This is when red blood cells are destroyed. There are many different causes,
    such as serious infections or certain medicines.
  • Sickle cell
    This is a type of hemoglobinopathy, an inherited type of anemia with
    abnormally-shaped red blood cells.
  • Cooley’s
    anemia (thalassemia). 
    This is another inherited type of anemia with
    abnormal red blood cells.
  • Aplastic
    This is failure of the bone marrow to make blood cells.

What causes anemia in a child?

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
  • Infections
  • Some diseases
  • Certain medicines
  • Lack of some vitamins or minerals in the diet

Which children are at risk for anemia?

Risk factors for anemia include:

  • Premature or low birth weight
  • Living in poverty or immigrating from developing country
  • Early use of 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

What are the symptoms of anemia in a child?

Most symptoms of anemia are due to
the lack of oxygen in the cells. Many of the symptoms do not occur with mild anemia.

These are the most common symptoms:

  • Increased heart rate
  • Breathlessness, or trouble catching a breath
  • Lack of energy, or tiring easily
  • Dizziness, or vertigo, especially when standing
  • Headache
  • Irritability
  • Irregular menstrual cycles
  • Absent or delayed menstruation
  • Sore or swollen tongue
  • Jaundice, or yellowing of skin, eyes, and mouth
  • Enlarged spleen or liver
  • Slow or delayed growth and development
  • Poor wound and tissue healing

The symptoms of anemia may look like other blood problems or health conditions.  Anemia is often a symptom of another disease. Be sure to report any symptoms to your child’s doctor. Always see your child’s doctor for a diagnosis.

How is anemia diagnosed in a child?

Because anemia is common in
children, doctors do routine screening for it. Plus, it often has no symptoms. Most
anemia in children is diagnosed with these blood tests:

  • Hemoglobin
    and hematocrit. 
    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
    A small sample of blood is examined under a microscope to see if they look

To get a blood sample, a healthcare
provider will insert a needle into a vein, usually in the child’s arm or hand. A
tourniquet may be wrapped around the child’s arm to help the healthcare provider find a
vein. Blood is drawn up into a syringe or a test tube. In some cases, blood can be taken
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 results of the
blood tests, your child may also have a bone marrow aspiration, biopsy, or both. This is
done by taking a small amount of bone marrow fluid (aspiration) or solid bone marrow
tissue (core biopsy). The fluid or tissue is examined for the number, size, and maturity
of blood cells or abnormal cells.