Anemia, one of the more common blood disorders, occurs when the level of healthy red blood cells (RBCs) in the body becomes too low. This can lead to health problems because RBCs contain hemoglobin, which carries oxygen to the body's tissues. Anemia can cause a variety of complications, including fatigue and stress on bodily organs.
Anemia can be caused by many things, but the three main bodily mechanisms that produce it are:
Among many other causes, anemia can result from inherited disorders, nutritional problems (such as an iron or vitamin deficiency), infections, some kinds of cancer, or exposure to a drug or toxin.
Hemolytic anemia occurs when red blood cells are being destroyed prematurely. (The normal lifespan of RBCs is 120 days; in hemolytic anemia, it's much shorter.) And the bone marrow (the soft, spongy tissue inside bones that makes new blood cells) simply can't keep up with the body's demand for new cells. This can happen for a variety of reasons. Sometimes, infections or certain medications — such as antibiotics or anti-seizure medicines — are to blame.
In autoimmune hemolytic anemia, the immune system mistakes RBCs for foreign invaders and begins destroying them. Other kids inherit defects in the red blood cells that lead to anemia; common forms of inherited hemolytic anemia include sickle cell anemia, thalassemia, glucose-6-phosphate dehydrogenase (G6PD) deficiency, and hereditary spherocytosis.
Blood loss can also cause anemia — whether it's because of excessive bleeding due to injury, surgery, or a problem with the blood's clotting ability. Slower, long-term blood loss, such as intestinal bleeding from inflammatory bowel disease (IBD), can also cause anemia. Anemia sometimes results from heavy menstrual periods in teen girls and women. Any of these factors will also increase the body's need for iron because iron is needed to make new RBCs.
Aplastic anemia occurs when the bone marrow can't make enough blood cells. This can be due to a viral infection, or exposure to certain toxic chemicals, radiation, or medications (such as antibiotics, anti-seizure drugs, or cancer treatments). Some childhood cancers can also cause aplastic anemia, as can certain genetic and other chronic diseases that affect the ability of the bone marrow to function properly.
High levels of hemoglobin and RBCs help fetal blood carry enough oxygen to developing babies in the relatively oxygen-poor environment in utero. After the child is born, more oxygen is available and the baby's hemoglobin level normally drops to a low point at about 2 months of age, a condition known as physiologic anemia of infancy. This temporary and expected drop in the blood count is considered normal and no treatment is required because the infant's body soon starts making RBCs on its own.
Anemia also occurs when the body isn't able to produce enough healthy RBCs because of an iron deficiency. Iron is essential to hemoglobin production. Poor dietary iron intake (or excessive loss of iron from the body) can lead to iron deficiency anemia, the most common cause of anemia in kids. Iron deficiency anemia can affect kids at any age, but is most common in those younger than 2 years old. Young children who drink excessive amounts of milk are at increased risk for iron deficiency.
Girls going through puberty also have a particularly high risk for iron deficiency anemia because of the onset of menstruation; the monthly blood loss increases the amount of iron they need to consume in their diets.
If your child has anemia, the first symptoms might be mild skin paleness and decreased pinkness of the lips and nailbeds. These changes may happen gradually, though, so they can be difficult to notice. Other common signs include:
If the anemia is caused by excessive destruction of RBCs, symptoms also may include jaundice, a yellowing of the whites of the eyes, an enlarged spleen, and dark tea-colored urine.
In infants and preschoolers, iron deficiency anemia can result in developmental delays and behavioral disturbances, such as decreased motor activity and problems with social interaction and attention to tasks. Research indicates that developmental problems may last into and beyond school age if the iron deficiency is not properly treated.
In many cases, doctors don't diagnose anemia until they run blood tests as part of a routine physical examination. A complete blood count (CBC) may indicate that there are fewer RBCs than normal. Other diagnostic tests may include:
In addition to running these tests, your doctor may ask about a family history of anemia and your child's symptoms and medications. This may lead the doctor to perform other tests to look for specific diseases that might be causing the anemia.
Treatment for anemia depends on its cause. It's important not to assume that any symptoms your child may be having are due to iron deficiency. Be sure to have your child checked by a doctor.
If your child has iron deficiency anemia, the doctor may prescribe medication as drops (for infants) or as a liquid or tablet (for older kids), which usually must be taken for as long as 3 months to rebuild the body's store of iron. The doctor also may recommend adding certain iron-rich foods to your child's diet or reducing milk intake.
If your teenage daughter is anemic and has heavy or irregular menstrual periods, her doctor may prescribe hormonal treatment to help regulate the bleeding.
Folic acid and vitamin B12 supplements may be prescribed if the anemia is traced to a deficiency of these nutrients, although this is rare in children.
Anemia caused by an infection will usually improve when the infection passes or is treated. If a certain medication appears to be the cause, your doctor may discontinue it or replace it with something else — unless the benefit of the drug outweighs this side effect.
Depending on the cause, treatment for more severe or chronic forms of anemia may include:
In some cases of sickle cell anemia, thalassemia, and aplastic anemia, bone marrow transplantation may be used. In this procedure, bone marrow cells taken from a donor are injected into the child's vein; they then travel through the bloodstream to the bone marrow and begin producing new blood cells.
The type, cause, and severity of your child's anemia will determine what kind of care is needed. Rest assured, though, that kids often tolerate anemia much better than adults.
In general, a child with significant anemia may tire more easily than other kids and therefore need to limit activity levels. Make sure that your child's teachers and other caregivers are aware of the condition. If iron deficiency is the cause, follow the doctor's directions about dietary changes and taking any iron supplements.
If the spleen is enlarged, your child may be prohibited from playing contact sports because of the risk that the spleen could rupture or hemorrhage if your child is hurt. Certain forms of anemia, such as sickle cell anemia, require other more specific kinds of care and treatment.
Whether anemia can be prevented depends on its cause. Currently, there is no way to prevent anemia due to genetic defects affecting the production of RBCs or hemoglobin.
However, you can help prevent iron deficiency, the most common form of anemia. Before following any of these suggestions, be sure to talk them over with your doctor:
If you have any questions about anemia or you think your child might have it, speak with your doctor.
Reviewed by: Robin Miller, MD
Date reviewed: September 2012
|Aplastic Anemia and MDS International Foundation, Inc. This group serves as a resource directory for patient assistance and emotional support while specializing in aplastic anemia and myelodysplastic syndrome cases.|
|Iron Disorders Institute Iron Disorders Institute's mission is to reduce pain, suffering, and death because of disorders such as hereditary hemochromatosis, acquired iron overload, porphyria cutanea tarda, sideroblastic anemia, thalassemia, African siderosis, iron deficiency anemia, and anemia of chronic disease.|
|National Heart, Lung, and Blood Institute (NHLBI) The NHLBI provides the public with educational resources relating to the treatment of heart, blood vessel, lung, and blood diseases as well as sleep disorders.|
|Sickle Cell Information Center The mission of this site is to provide patient and professional education, news, research updates, and sickle cell resources.|
|Centers for Disease Control and Prevention (CDC) The CDC (the national public health institute of the United States) promotes health and quality of life by preventing and controlling disease, injury, and disability.|
|American Society of Hematology This group provides information relating to blood, blood-forming tissues, and blood diseases.|
|Anemia Las personas que sufren de anemia tienen menos glóbulos rojos de lo normal.|
|Word! Anemia People who have anemia have fewer red blood cells than normal, which can make them feel tired because not enough oxygen is getting to their bodies' cells.|
|Sickle Cell Anemia More than 70,000 Americans have sickle cell anemia, which occurs when someone inherits two abnormal genes that cause red blood cells to change shape. Find out more.|
|Blood Test: Hemoglobin Electrophoresis A hemoglobin electrophoresis can help diagnose diseases involving abnormal hemoglobin production, and often is performed as part of newborn screening tests.|
|Do You Know About Sickle Cell Anemia? Sickle cell anemia gets its name because a person's red blood cells turn from a doughnut shape into a curved sickle shape. What's a sickle look like?|
|Word! Red Blood Cells Red blood cells have the important job of carrying oxygen.|
|Iron and Your Child Iron is an essential nutrient that is needed to make hemoglobin, the oxygen-carrying component of red blood cells.|
|Blood Transfusions A blood transfusion is a safe and relatively simple medical procedure that replaces blood lost during surgery or because of an injury or illness.|
|Alpha Thalassemia Alpha thalassemia is a blood disorder in which the body has a problem producing alpha globin, a component of hemoglobin, the protein in red blood cells that transports oxygen throughout the body.|
|Beta Thalassemia Beta thalassemia is a blood disorder in which the body has a problem producing beta globin, a component of hemoglobin, the protein in red blood cells that transports oxygen throughout the body.|
|Menstrual Problems For a girl, getting her first period is a sign of becoming a woman. But it can also be confusing, particularly if she encounters certain menstrual problems like irregular periods or PMS.|
|Blood Transfusions About 5 million people a year get blood transfusions in the United States. This article explains why people need them and who donates the blood used.|
|Becoming a Vegetarian People choose vegetarianism for a variety of reasons. This article describes different types of vegetarianism and provides advice on ways for vegetarians to get all the nutrients they need.|
|Sickle Cell Disease Thanks to advancements in early diagnosis and treatment, most kids born with sickle cell disease grow up to live relatively healthy and productive lives.|
|G6PD Deficiency An inherited condition, G6PD deficiency is when someone doesn't have enough of the enzyme G6PD, which protects red blood cells. Certain triggers can lead to anemia in kids who have G6PD deficiency.|
|Anemia Anemia is common in teens because they undergo rapid growth spurts, when the body has a greater need for nutrients like iron. Learn about anemia, including how to lower your risk of getting it and how it's treated.|
|About Anemia What does it mean when a kid has anemia? Learn about anemia, why kids get it, and how it's treated in our article for kids.|
|Spleen and Lymphatic System The lymphatic system is an extensive drainage network that helps keep bodily fluid levels in balance and defends the body against infections.|
|Blood Test: Ferritin (Iron) Doctors may order a ferritin test when they suspect kids have too little or too much iron in their bodies.|
|Blood Test: Reticulocyte Count This test measures the rate at which reticulocytes (immature red blood cells) are made in the bone marrow and enter the bloodstream. A reticulocyte count can provide information about a child's anemia.|
|Blood Test: Complete Blood Count The complete blood count (CBC) is the most common blood test. It analyzes red blood cells, white blood cells, and platelets.|
|Iron-Deficiency Anemia Iron helps the body carry oxygen in the blood and plays a key role in brain and muscle function. Too little iron can lead to iron deficiency anemia. Read more here.|
|Blood Without blood, our organs couldn't get the oxygen and nutrients they need, we couldn't keep warm or cool off, we couldn't fight infections, and we couldn't get rid of our own waste products. Find out about the mysterious, life-sustaining fluid called blood.|
|Blood Blood is vital to bodily function. Read this article for the basics about blood, blood cells, blood diseases, and more.|
|The Truth About Transfusions Blood transfusions can save lives. But how do they work? Find out in this article.|
|Coping With Common Period Problems Many girls have to deal with PMS, cramps, or headaches around the time of their periods. These problems are usually nothing to worry about. Get the facts on which period problems are normal and which ones might indicate something's going on.|
What to expect when coming to Akron Children's
For healthcare providers and nurses
Residency & Fellowships, Medical Students, Nursing and Allied Health
For prospective employees and career-seekers
Our online community that provides inspirational stories and helpful information.