Anemia In Children – Causes, Symptoms And Treatment

Medically reviewed by Dr. Arun Wadhwa, MD Dr. Arun Wadhwa Dr. Arun WadhwaMD facebook_icon Specialty: PediatricsExperience: 30 years
Written by Dr Bisny T. Joseph
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Around 7% of our body weight is made up of blood. Up to 45% of the blood is made up of red blood cells (1).

We need red blood cells (RBC) to transport oxygen and infection-fighting antibodies to different parts of the body. RBCs also regulate body temperature and help the blood transport waste products to kidneys and liver, thereby cleaning and filtering the blood. When the body lacks enough red blood cells to perform these functions, it leads to a condition called anemia.

MomJunction tells you everything you need to know about anemia in children, its symptoms, diagnosis, and treatment options.

Causes Of Anemia In Children

Ideally, a child should have anywhere between 3.9 and 5.3 million red blood cells per microliter of blood (2). The ideal RBC count varies from one child to another, depending on the child’s age. Your child may be anemic if he or she:

  • Has a low production of red blood cells. This is often the result of poor nutrition and iron deficiency. This condition is referred to as iron-deficiency anemia.
  • Has an underlying illness or an inherited blood disorder such as sickle cell anemia, which results in excessive destruction of red blood cells.
  • Has lost a lot of blood due to an injury or due to long-term, low-grade blood loss such as in stools. In girls, this could also happen due to excessive menstrual bleeding.
  • Younger children (aged less than three) who drink a lot of cow’s milk without other nutritious foods may also end up anemic (3).

A little bit of bleeding does not make a person anemic. That said, you should not rule out anemia without checking for the symptoms first.

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Types Of Anemia

There are different types of anemia in children, depending on what is causing it. They are:

  • Iron-deficiency anemia
  • Megaloblastic anemia or macrocytic anemia, which is caused due to vitamin B-12 deficiency
  • Hemolytic anemia, an inherited condition that develops when the body produces damaged red blood cells
  • Sickle cell anemia, which is abnormal hemoglobin (red blood cells) that are distorted or sickled. These damaged cells are delicate and can get ruptured easily. This is an inherited disorder
  • Thalassemia or Cooley’s anemia is also an inherited disorder due to which the body produces abnormal red blood cells. Thalassemia could be alpha or beta, which could be major or minor (4).
  • Chronic anemia or anemia of chronic condition is usually in people who have chronic medical conditions involving inflammation.
  • When the bone marrow is unable to produce enough red and white blood cells, it leads to aplastic anemia in children.

The symptoms of different anemia are similar:

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Symptoms Of Anemia

Common symptoms of anemia in children include:

  • Severe exhaustion
  • Irritability
  • Lightheadedness
  • Headache
  • Mild weakness
  • Rapid heartbeat
  • Shortness of breath
  • Craving for unusual foods such as chalk
  • Loss of appetite
  • Sore or swollen tongue

Signs that could indicate anemia in your child are:

  • Pale skin
  • Pale eye whites, maybe with a tinge of blue here and there
  • Brittle nails
  • Problem in healing tissues or wounds
  • Delayed growth and development

Children with anemia need not necessarily have all the above symptoms. Proper medical diagnosis is the only way to be sure if the child is anemic.

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How Is Anemia Diagnosed?

Diagnosis of anemia primarily consists of a physical examination of the child, followed by a complete blood count (CBC). The CBC test gives a detailed account of the number of red and white blood cells in the body. In addition to that, the medical practitioner may also suggest the following blood tests and diagnostics.

  • Blood smear exam, which involves observing the RBCs to determine the cause of anemia
  • Iron tests to determine if the child has an iron deficiency
  • Hemoglobin electrophoresis, which can detect any abnormalities in the red blood cells, and diagnose sickle cell anemia and thalassemia
  • Bone marrow aspiration lets the doctors understand the activity in the bone marrow and can contribute to diagnosing aplastic anemia. Biopsy of the bone marrow cells can also assist in detecting any form of leukemia that may have affected the organ
  • The reticulocyte count is to determine the count of young red blood cells. This is done to see if the RBC production in the body is normal.

The results of the diagnostic tests determine the course of treatment for anemia.

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Anemia Treatment For Children

Treatment for anemia in children varies based on the diagnosis, age of the child, medical history and, overall health of the child, and his or her tolerance to specific medications (5). Treatment options include:

  • Iron or B-12 supplements in case of iron-deficiency anemia and macrocytic anemia.
  • Change in the diet to include more iron-rich or vitamin B-12 rich foods.
  • If anemia is caused by an infection or any medical condition, treating the infection or the condition will treat anemia .
  • Blood transfusion may become necessary to treat some forms of chronic anemia.
  • Use of medication to treat the spleen. In some cases, removal of the spleen may be necessary.
  • Medication may also be given to fight a bone marrow infection or to stimulate the bone marrow to produce more blood cells.

Bone marrow transplantation may be recommended in severe cases of aplastic anemia.

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How To Prevent Nutritional Anemia?

Nutritional anemia, or anemia not caused due to an inherited blood disorder, can be avoided by taking a few precautions such as:

  • Limiting the intake of cow’s milk in children less than one year can protect them from possible iron deficiency in the future (6).
  • B-12 deficiency anemia can also be prevented by ensuring that the child’s diet includes foods rich in vitamin B-12.
  • Add citrus fruits in the diet to increase the iron absorption levels in the child. This is especially helpful when your child’s source of iron is plant based.

Inherited anemias such as sickle cell anemia, thalassemia, or hemolytic anemia cannot be prevented.

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Home Remedies For Anemia

Giving your child a healthy diet rich in minerals and vitamins can prevent or minimize the chances of them developing anemia. These natural home remedies will be useful if your child is anemic and is undergoing treatment for the same.

  1. Beetroot is beneficial for kids, especially teenagers who have anemia (7). Blend a medium beetroot with carrots and sweet potato and give the juice to the child once daily.
  1. Spinach and other green vegetables and fruits are rich in iron (8). So if the child has iron-deficiency anemia, a cup or two of spinach soup every day can help.
  1. Blackstrap molasses is rich in iron, vitamin B, and minerals. A spoonful of blackstrap molasses in a glass of warm water can contribute to improving the child’s iron levels considerably.
  1. Dates are rich in vitamin C and can improve the body’s iron absorption levels. Soak two dates overnight in a cup of milk. Get the child to drink the milk and eat the dates on an empty stomach.
  1. Bananas are rich in iron and can boost the production of red blood cells in the body. They are also rich in magnesium and support hemoglobin synthesis in the body.
  1. Apples, rich in vitamin C, also aid in improving iron absorption in the body.
  1. The high iron content in fenugreek will aid in maintaining the iron levels in the body, thereby aiding the production of hemoglobin.
  1. Red meat is the richest and fastest source of iron. Vegetarian food is rich in iron but it is difficult to absorb due to the presence of phytates

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Eliminating certain foods with added sugars and artificial sweeteners, processed grains, chocolate, soda, coffee, and bran can also improve the iron levels in the body. Use of probiotics will help your child maintain a clean gut, which in turn enables the body to absorb nutrients better.

If your child’s diet is not enough to provide sufficient nutrition, then consider giving supplements, but only after consulting your doctor.

Have any tips on dealing with anemic children? Share them with the other parents here.

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Dr. Arun Wadhwa has more than 30 years of experience as a pediatrician. He operates his own clinic in South Delhi and is also associated with the Madhukar Rainbow Children's Hospital.Dr. Wadhwa completed his graduation and post-graduation from the University College of Medical Sciences and the associated Safdarjang Hospital, New Delhi.

Read full bio of Dr. Arun Wadhwa
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