Anemia (Low hemoglobin): A-to-Z Guide from Diagnosis to Treatment to Prevention

Anemia

Introduction to anemia:

Blood is a straw-colored liquid packed with red blood cells (that deliver oxygen to the body), white blood cells (that provide protection from infections), and platelets (little clumps that help the blood clot when needed). The red blood cells carry oxygen from the lungs to every part of the body. They also give the blood its characteristic dark red color. This steady supply of oxygen to the body’s tissues is necessary for health, for growth, and for life itself.

What is anemia?

When you don’t have adequate red blood cells in your blood, you have anemia.

Normally about 1 percent of the red blood cells retire every day, to be replaced by about the same number of fresh, young red blood cells. Each red blood cell lives approximately 120 days.

Anemia occurs when the production of red blood cells is insufficient, when too many red blood cells are destroyed, or when blood is lost (through bleeding).

Who gets anemia?

There are many, many reasons a child might become anemic.

The most common reason for a child to be anemic is an inadequate supply of iron. Iron is a mineral that your body needs in order to make red blood cells. Children who lack enough iron will make small, pale, ineffective red blood cells.

Low levels of other nutrients, such as folic acid, can also cause anemia. This is most common in children primarily fed goat’s milk, which is low in folic acid.

Many viral illnesses will cause brief anemia in otherwise healthy children.

Some children have red blood cells that are fragile and easily broken. This often occurs in hereditary conditions.

Sickle cell anemia is one type of hereditary anemia where the red pigment, called hemoglobin, is not made normally.

Some children have anemia from blood loss. This can either be obvious blood loss, or long-term low-grade blood loss, perhaps in the stool. A cow’s milk allergy, for instance, is a common cause of hidden blood loss.

Exposure to toxins, such as lead, can also cause anemia.

What are the symptoms of anemia?

Mild anemia might cause no obvious symptoms.

Anemia can make children feel tired, weak, and cranky. It can cause pale skin, headaches, and a poor appetite. Kids with anemia tend to get sick more often. Their brains and muscles are also affected.

Prolonged or severe anemia can cause marked irritability, decreased appetite, and slowed growth. In very severe cases, children can even go into heart failure.

Some specific types of anemia have specific symptoms, such as the pain crises associated with sickle cell anemia.

Is anemia contagious?

Anemia is not contagious, although some of the underlying causes can be.

How long does anemia last?

Anemia will last until bone marrow production is able to adequately replenish the supply of red blood cells. How long this takes depends on the degree of anemia and on the underlying cause. Some anemias are only brief episodes while others may last a lifetime.

How is anemia diagnosed?

Most children get a screening blood test between 6 and 18 months of age to look for anemia. The blood test is important because it can identify anemia before there are any symptoms.

Anemia on the screening blood test is not necessarily caused by iron deficiency, although mild anemia in an otherwise well child is most often caused by iron deficiency.

Further blood tests (and perhaps a search for sources of bleeding) can pinpoint the type of anemia.

How is anemia treated?

Because there are so many types of anemia, it is important to work with your pediatrician to determine what is really going on.

If the history and physical exam are consistent with iron deficiency, iron supplements may be given for about a month to see if there is a response. If the anemia has not improved in this time, further testing is warranted before further treatment.

How can anemia be prevented?

See articles on iron deficiency, lead exposure, and sickle cell anemia for specific prevention strategies for different types of anemia.

Related A-to-Z Information:

Breath holding, Fifth disease, Food allergies, Hemophilia, Iron deficiency, Jaundice (Bilirubin, Hyperbilirubinemia), Lead poisoning, Nosebleeds (Epistaxis), Parvovirus, Sickle cell anemia

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Dr. Alan Greene

Dr. Greene is the founder of DrGreene.com (cited by the AMA as “the pioneer physician Web site”), a practicing pediatrician, father of four, & author of Raising Baby Green & Feeding Baby Green. He appears frequently in the media including such venues as the The New York Times, the TODAY Show, Good Morning America, & the Dr. Oz Show.