How do i know if my child is anemic
Anemia in Children and Teens: Parent FAQs
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Anemia is a condition in which the amount of red blood cells in the body is decreased below normal for your child's age. It can make your child appear pale in color and feel cranky, tired, or weak. Though these symptoms may worry you, the most common causes of anemia―such as iron deficiency―are generally easy to treat, especially when it is detected early. In addition, parents need to be aware of the steps to take to prevent this condition.
Because rapid growth is a potential cause of the condition, the first year of life and adolescence are two age groups where infants and children are especially prone to anemia.
What is anemia?
Anemia means there are not enough red blood cells in the body. Red blood cells are filled with hemoglobin, a special pigmented protein that makes it possible to carry and deliver oxygen to other cells in the body. The cells in your child's muscles and organs need oxygen to survive, and decreased numbers of red blood cells can place stress on the body.
Your child may become anemic if his or her body:
Does not produce enough red blood cells. This can happen if she does not have enough iron or other nutrients in her diet (e.g. iron-deficiency anemia).
Destroys too many red blood cells. This type of anemia usually happens when a child has an underlying illness or has inherited a red blood cell disorder (e.g. sickle-cell anemia).
Loses red blood cells through bleeding. This can either be obvious blood loss, such as heavy menstrual bleeding, or long-term low-grade blood loss, perhaps in the stool.
What are the common signs and symptoms of anemia?
- Pale or sallow (yellow) skin
- Pale cheeks and lips
- Lining of the eyelids and the nail beds may look less pink than normal
- Irritability
- Mild weakness
- Tiring easily, napping more frequently
- Children experiencing red blood cell destruction may become jaundiced (yellowing of the skin or eyes) and have dark tea or cola-colored urine
Children with severe anemia may have additional signs and symptoms:
- Shortness of breath
- Rapid heart rate
- Swollen hands and feet
- Headaches
- Dizziness and fainting
- Restless leg syndrome
When kids eat non-foods:
Children with anemia caused by very low levels of iron in their blood may also eat strange non-food things such as ice, dirt, clay, paper, cardboard, and cornstarch. This behavior is called "pica" (pronounced pie-kuh).
Pica often occurs in children who are low in iron and can cause constipation. In these children, the pica usually stops after the anemia is treated with iron supplements.
If your child shows any of these signs or symptoms, please see your pediatrician.
Even a low level of anemia can affect your child's energy, focus, and ability to learn. Chronic iron deficiency anemia can result in long term, permanent impairment of development. In most cases, a simple blood count can diagnose anemia.
How can I prevent my child from becoming anemic?
Iron-deficiency anemia and other nutritional anemias can be prevented by ensuring that your child eats a well-balanced diet. Talk with your doctor about any specific dietary restrictions in your household as your child
may require a nutritional supplementation to prevent anemia.
Here are ways to prevent nutritional anemias:
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Giving cow's milk before your child is ready may cause blood loss in his or her stool and can also decrease the amount of iron absorbed in the gut.
How can I manage anemia if my child has an inherited red blood cell disorder?
Your pediatrician will likely refer you to a pediatric hematologist to provide you with supportive care and education on your child's specific condition.
Remember:
If your child starts to show any signs or symptoms of anemia, be sure to tell your pediatrician.
Also, find out if anyone in your family has a history of anemia or problems with easy bleeding. With proper treatment, your child's anemia should improve quickly.
Additional Information:
Pump Up the Diet with Iron
Vitamin D & Iron Supplements for Babies: AAP Recommendations
- Last Updated
- 1/24/2019
- Source
- AAP Section on Hematology/Oncology (SOHO) ＆ AAP Committee On Nutrition (CON) (Copyright © 2019)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
Iron-Deficiency Anemia in Children | Cedars-Sinai
ABOUT CAUSES DIAGNOSIS TREATMENT NEXT STEPS
What is iron-deficiency anemia in children?
Anemia is a common health problem in children.
The most common cause of anemia is not getting enough iron. A child who is anemic does not have enough red blood cells or enough hemoglobin. Hemoglobin is a protein that lets red blood cells carry oxygen to other cells in the body. Iron is needed to form hemoglobin.
What causes iron-deficiency anemia in a child?
Iron-deficiency anemia can be caused by:
- Diets low in iron. A child gets iron from the food in his or her diet. But, only a small amount of the iron in food is actually absorbed by the body.
- Full-term newborns, born to healthy mothers, have iron that they get during the last 3 months of pregnancy.
- Infants of mothers with anemia or other health problems may not have enough iron stored. And infants born early may not get enough iron.
- At 4 to 6 months of age, the iron stored during pregnancy is at a low level.
And more iron is used as the infant grows. - The American Academy of Pediatrics (AAP) advises feeding your baby only breastmilk for the first 6 months. But breastmilk does not have a lot of iron, so infants that are breastfed only, may not have enough iron.
- Older infants and toddlers may not get enough iron from their diets.
- Body changes. When the body goes through a growth spurt, it needs more iron for making more red blood cells.
- Gastrointestinal tract problems. Poor absorption of iron is common after some forms of gastrointestinal surgeries. When you eat foods containing iron, most of the iron is absorbed in the upper small intestine.
Any abnormalities in the gastrointestinal (GI) tract could alter iron absorption and cause iron-deficiency anemia. - Blood loss. Loss of blood can cause a decrease of iron. Sources of blood loss may include gastrointestinal bleeding, menstrual bleeding, or injury.
What are the symptoms of iron-deficiency anemia in a child?
These are the most common symptoms of iron-deficiency anemia:
- Pale skin
- Irritability or fussiness
- Lack of energy or tiring easily (fatigue)
- Fast heart beat
- Sore or swollen tongue
- Enlarged spleen
- Wanting to eat odd substances, such as dirt or ice (also called pica)
How is iron-deficiency anemia diagnosed in a child?
In most cases, anemia is diagnosed with simple blood tests.
Routine anemia screening is done because anemia is common in children and they often have no symptoms.
- The AAP recommends anemia screening with a hemoglobin blood test for all infants at 12 months of age. The screening should also include a risk assessment. This is a group of questions to find risk factors for iron-deficiency anemia. Risk factors include feeding problems, poor growth, and special healthcare needs.
- If the hemoglobin level is low, more blood tests are done.
- If your child has a risk factor at any age, blood tests are done.
- Blood tests for anemia may also be done during routine physical exam or checkups in children of any age.
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 smear.A small sample of blood is examined under a microscope. Blood cells are checked to see if they look normal or not.
- Iron studies. Blood tests can be done to measure the amount of iron in your child's body.
How is iron-deficiency anemia treated in a child?
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
To prevent iron-deficiency anemia, the AAP says:
- Beginning at 4 months of age, infants that are only breastfed or partially breastfed should be given a daily iron supplement until they begin eating iron-rich foods.
- Infants that are formula-fed do not need iron supplements. The formula has iron added to it. Whole milk should not be given to infants less than 12 months old.
- Infants and toddlers from 1 to 3 years old should have foods rich in iron. They include cereal that has iron added, red meats, and vegetables with iron. Fruits with vitamin C are also important. The vitamin C helps the body absorb the iron.
Treating iron-deficiency anemia includes:
- Iron supplements. Iron drops or pills are taken over several months to increase iron levels in the blood. Iron supplements can irritate the stomach and discolor bowel movements.
They should be taken on an empty stomach or with orange juice to increase absorption. They are much more effective than dietary changes alone. If the child can’t take drops or pills, IV iron may be needed, but this is very unusual. - Iron-rich diet. Eating a diet with iron-rich foods can help treat iron-deficiency anemia. Good sources of iron include:
- Iron-enriched cereals, breads, pasta, and rice
- Meats, such as beef, pork, lamb, liver, and other organ meats
- Poultry, such as chicken, duck, turkey, (especially dark meat), and liver
- Fish, such as shellfish, including clams, mussels, and oysters, sardines, and anchovies
- Leafy greens of the cabbage family, such as broccoli, kale, turnip greens, and collards
- Legumes, such as lima beans and green peas; dry beans and peas, such as pinto beans, black-eyed peas, and canned baked beans
- Yeast-leavened whole-wheat bread and rolls
What are possible complications of iron-deficiency anemia in a child?
Iron-deficiency anemia may cause delayed growth and development.
What can I do to prevent iron-deficiency anemia in my child?
You can often prevent iron-deficiency anemia through screening and taking iron supplements.
When should I call my child's healthcare provider?
Call your child's healthcare provider if your infant is not nursing well. Or if your toddler or child has any of the signs of iron-deficiency anemia.
Key points about iron-deficiency anemia in children
- Iron-deficiency anemia is not having enough iron in the blood. Iron is needed for hemoglobin.
- Breastfed only infants should be given iron beginning at 4 months of age.
- When infants are 12 months old, they should be screened for iron-deficiency anemia.
- Iron supplement and iron-rich foods are used to treat iron-deficiency anemia.
Next steps
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 provider after office hours. This is important if your child becomes ill and you have questions or need advice.
Anemia in children | City Children's Hospital
What is anemia
Anemia is a decrease in the total concentration of red blood cells and hemoglobin in the blood. The task of red blood cells is to deliver oxygen to the tissues of the body. Therefore, with a decrease in their number, the body suffers from the so-called hypoxia - lack of oxygen. Children are especially sensitive to a decrease in hemoglobin.
According to statistics, anemia occurs in 15% of children. Anemias are very different - some are associated with a lack of B vitamins, others - with a lack of folic acid. But the vast majority of anemia develops due to iron deficiency. These anemias are called iron deficiency, and they are the most common (about 90% of all anemias). Let's talk about iron deficiency anemia today.
Causes and symptoms of anemia
Causes of iron deficiency anemia are divided into three groups.
The first is the situation associated with blood loss.
This includes bleeding from the gastrointestinal tract, menstrual bleeding, and any other blood loss.
The second group includes the lack of iron. And although this is possible only when fasting, this happens in children. For example, when vegetarian parents intentionally deprive their child of meat food - the main source of heme iron.
The next group of causes is iron malabsorption. With some diseases of the stomach or intestines, after abdominal operations on the gastrointestinal tract. The fact is that iron is absorbed mainly in the duodenum and in the upper sections of the small intestine. Therefore, any problems with these parts of the gastrointestinal tract can provoke anemia.
Anemia can also occur when there is insufficient production of red blood cells, impaired functioning and premature destruction of red blood cells.
Your child is pale, gets tired quickly, complains of muscle weakness, dizziness. These are the first signs of anemia. Such situations are typical for both schoolchildren and preschool children.
Attentive parents will immediately go to see the doctor. If anemia is started, then soon your child will become inactive, cracks will appear in the corners of the mouth, the tongue will become smooth and glossy, “flies” will flash before the eyes. There will be perversions in food desires, especially the desire to lick nails and other metal objects.
Your task as parents and as your doctor is to identify its type, causes and eliminate iron deficiency.
Diagnosis and treatment of anemia
In order to confirm the diagnosis of "anemia", you need to pass an elementary complete blood count (from a finger). According to its results, it will be seen how critical the condition of the child is. If hemoglobin (HGB) is between 90 and 110, it is mild anemia; 90-70 - anemia of moderate severity; a score below 70 is a warning sign of severe anemia. Pay attention to the number of erythrocytes in the blood (RBC). Their norm for children is 4.0-7x1012 (depending on age).
A very important indicator of anemia is the color index of the blood.
Normally, it should be equal to one. If its value is higher than 1.05, it becomes clear that anemia is caused by a deficiency of B vitamins or folic acid. If the CPU is less than 0.85, iron deficiency anemia is suspected. There are other criteria based on which the diagnosis of IDA is made, but we will provide their analysis to a knowledgeable doctor.
After the diagnosis is made, the doctor must determine the cause of the anemia, and you must help him with this. Be sure to tell your doctor if suddenly your child does not eat meat or fish, if he has gastrointestinal diseases (ulcerative and pre-ulcerative bowel conditions). It is very important to find out and eliminate the root cause of anemia, otherwise no treatment will give results, and after a few months anemia will reappear. Treatment of anemia should be comprehensive. Diet can eliminate only a small lack of iron, more serious situations require complex treatment that combines both a special diet and medications. But more on that later.
Treatment should ONLY be prescribed by a physician. And it is better if it is a qualified hematologist. An excess of iron is just as dangerous for a child's body as its deficiency. Therefore, self-medicating, you run the risk of seeing overdose symptoms - cramps, vomiting and diarrhea.
Modern iron preparations are available in easy to take forms such as syrups, drops and even chewable tablets. For mild anemia, oral medication is sufficient. Moreover, it is better to drink them with juice, and be sure to take them outside of food! If the anemia is severe, hospital treatment, parenteral administration of drugs, and sometimes even blood transfusion are indicated. Therefore, do not risk the health of children and, at the slightest suspicion, seek medical help.
Nutrition for anemia. Prevention of anemia
Understanding the mechanism of absorption of iron from various sources is important for the formation of the correct principles of nutrition for a child.
The fact is that in red meat, liver and eggs, iron is contained in a quickly digestible form - the so-called heme (heme) iron. Plant foods (legumes, buckwheat, pomegranates) are a storehouse of non-heme (non-heme) iron, which is absorbed worse. Therefore, the child's menu must contain meat (beef, rabbit - 30 grams per day), sea fish, eggs (1-2 pieces), berries and juices rich in ascorbic acid. It is ascorbic acid and animal protein that improve the absorption of iron (with simultaneous use 3 times!). While whole milk and dairy products should be eaten separately from meat, fish and eggs.
It used to be believed that apples contained a lot of iron. This is not true, since there is exactly as much iron in apples as there is in buckwheat. Just apples contain ascorbic acid, which improves the absorption of iron. Therefore, you do not need to force-feed the child with apples, and if he does not like berries and juices, it is better to give the good old ascorbic vitamin. By the way, few people know that dried porcini mushrooms (35 mg per 100 g), seaweed (16 mg per 100 g), cocoa powder (15 mg per 100 g), liver (9mg per 100 g).
Don't get sick!
How to recognize an iron deficiency?
Iron is an essential element for our body, it is part of hemoglobin, which is a component of erythrocytes - red blood cells.
Thanks to hemoglobin, the cells of our body receive oxygen. Iron deficiency anemia is a pathology that leads to a decrease in the level of hemoglobin and red blood cells in the blood, and, as a result, to hypoxia of tissues and organs. Why is this condition dangerous and how to restore iron levels?
Why is there not enough iron?
Iron deficiency can develop in both adults and children, and there are many reasons for this. It is impossible to ignore this disease, because against the background of a lack of oxygen, all organs of our body suffer, but this condition is especially dangerous for the brain.
Iron is not produced in the body on its own, therefore, to maintain the required norm, a combination of a number of factors is important, such as nutrition, digestibility of food and the presence of any diseases.
The most common causes of iron deficiency anemia are:
1. Insufficient intake of iron from food. Irregular and unbalanced diet is one of the main causes of iron deficiency. Vegetarians, as well as people subjecting themselves to strict diets, are at risk. Also, iron deficiency anemia can develop against the background of a decrease in the level of iron absorption in diseases of the gastrointestinal tract, as well as in old age.
2. Chronic blood loss associated with diseases: frequent nosebleeds, heavy menstruation, gastrointestinal bleeding, helminthiasis, chronic infections and other pathologies. Also, acute blood loss as a result of trauma or uncontrolled donation can lead to iron deficiency.
3. Individual increase in daily iron intake. The body's need for iron may increase at the time of active growth in children and adolescents, in girls during the formation of the menstruation cycle, in pregnant and lactating women, with strong physical exertion, etc.
Symptoms and diagnosis of iron deficiency anemia
In the modern rhythm of life, symptoms iron deficiency can be confused with manifestations of many other diseases, therefore, in order to make a diagnosis and prescribe treatment, it is necessary to visit a doctor and take tests.
Symptoms of iron deficiency:
- fatigue, drowsiness, poor performance;
- frequent dizziness, headache;
- pale skin, numbness of extremities, chilliness;
- lack of air, tinnitus, blurred vision;
- tachycardia, dyspnea, chest pain;
- change in taste preferences;
- hair loss, brittleness and changes in the structure of nails.
To diagnose iron deficiency anemia, your doctor will order a series of blood tests, which usually include:
- Clinical and biochemical blood tests.
- Serum iron concentration.
- Serum ferritin and transferrin.
Additionally, examinations can be prescribed to identify the cause of anemia:
- Gastroscopy - endoscopic examination of the digestive tract.
- Colonoscopy – endoscopic examination of the large intestine.
- Abdominal ultrasound.
- Gynecological examination.
- ECG.
Prevention and treatment of iron deficiency
Treatment of iron deficiency anemia is prescribed exclusively by a doctor based on the results of examinations and tests. If the hemoglobin level in an adult and a child from 6 years old is less than 90 g / l, then this indicates the presence of a deficiency, less than 70 g / l is considered a severe degree of the disease. Up to 6 years of age, the hemoglobin index in the blood of children should be at least 110 g / l.
First of all, a balanced diet is recommended, as well as treatment of diseases that have caused anemia. To adjust the level of hemoglobin, the doctor may prescribe medications for ferrous and ferric iron. Dosage and frequency of administration is discussed with the doctor individually. Usually the course of treatment lasts from 3 to 4 months.
