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 doesn't 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 body.
There are many types of anemia. Your child may have one 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 a 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.
Cooley's anemia (thalassemia). 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.
What causes anemia in a child?
Anemia has three main causes:
Decreased red blood cells or hemoglobin levels may be due to:
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
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
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
don't 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
Irregular menstrual cycles
Absent or delayed menstruation
Sore or swollen tongue
Yellowing of skin, eyes, and mouth (jaundice)
Enlarged spleen or liver
Slow or delayed growth and development
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.
How is anemia diagnosed in a child?
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
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). 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 look
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 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 blood test results, 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 checked for the
number, size, and maturity of blood cells or abnormal cells.
How is anemia in a child treated?
Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how bad the condition is.
The treatment for anemia depends on the cause. Some types don't need treatment. Other
types may need medicine, blood transfusions, surgery, or stem cell transplants. Your
child's healthcare provider may refer you to a hematologist. This is a specialist
in treating blood disorders. Treatment may include:
Vitamin and mineral drops or pills
Changing your child's diet
Stopping a medicine that causes anemia
Stem cell transplants
Surgery to remove the spleen (very rare)
What are possible complications of anemia in a child?
The complications of anemia depend on what is causing it. Some types have few complications.
But others have frequent and serious complications. Some anemias may cause:
What can I do to prevent anemia in my child?
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 possible. They will get enough iron from your breastmilk until about 4 months of age. At 4
months, add an iron supplement.
Give formula with iron. If your child is on formula, use formula with added iron.
Don't give cow’s milk until after age 1. 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 red blood cells.
Feed your child iron-rich foods. 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,
When should I call my child's 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.
Key points about anemia in children
Anemia is a low red blood cell count or a low hemoglobin level. It's a common problem
There are many different types of anemia.
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 illnesses.
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 healthcare provider after office hours, and
on weekends and holidays. This is important if your child becomes ill and you have
questions or need advice.