Causes
Anaemia occurs when the level of haemoglobin in your the blood is lower than it should be. There are three main causes of anaemia:
- not enough haemoglobin being produced (often because of a dietary deficiency)
- not enough red blood cells being produced by the bone marrow
- too many red blood cells dying off (known as haemolysis).
The most common cause of childhood anaemia is a low level of iron in the body, usually because the child isn’t getting enough iron in his diet. Iron is essential for your child’s body because it helps form haemoglobin.
A newborn baby usually has enough iron stores from her mother to last for the first six months of life (this might not be the case if your baby was born prematurely or was very sick as a newborn, or if you were iron-deficient during late pregnancy). Once these stores are used up, your baby will need iron in her diet.
At around 4-6 months of age, you can introduce solids to your baby’s diet. Cereals, vegetables, eggs and meat, for example, all contain iron.
If your baby drinks a lot of cows milk, his overall diet might not have enough iron. This is because cows milk is a poor source of iron and can prevent the gut from absorbing iron properly. Also, drinking too much milk can decrease your baby’s appetite for solids. Iron deficiency is rarely a problem for breastfed babies, or babies who are on formula feeds.
Adolescent girls are at risk of iron-deficiency anaemia if they have frequent, prolonged or very heavy periods.
Symptoms
If your child has anaemia, she might look very pale. A toddler might get very tired. Given usual toddler energy levels, this might be hard to spot.
Your child might be irritable and hard to manage. Older children might be very tired, have a poor appetite and find it hard to concentrate at school.
If your child’s anaemia is caused by something other than iron deficiency, he might show specific symptoms of this underlying cause.
When to see your doctor
Take your child to the doctor if your child looks very pale, or is irritable, lethargic or complaining of frequent headaches. It’s also a good idea to see your doctor or child health nurse if you want extra information about what to feed your baby – for example, if your child drinks large volumes of milk and doesn’t eat solids.
Tests
If your child has anemia, your doctor will usually order blood tests to discover the cause. Sometimes the results of the initial blood tests will indicate that other tests are needed. In this case, you might need to see a children’s specialist (paediatrician) or blood specialist (haematologist).
Treatment
The treatment of anaemia depends on the cause.
If the cause is poor bone marrow function or haemolysis, further investigation and treatment might be needed. If your child has anaemia caused by not enough iron, adding iron-rich foods to her diet can help boost her iron levels. Iron-rich foods include:
- iron-fortified cereals
- legumes (such as lentils and beans)
- meat (red meat, chicken and fish)
- egg yolk
- green vegetables
- crushed sesame seeds (such as tahini or halva).
Changing your child’s diet alone might not be enough. He might also need to take iron supplements (tablets or syrup) to help get his iron levels back to normal. Iron supplements can turn your child’s stools black or grey, and might cause constipation or tummy upsets.
Occasionally, an infusion or injection of iron might be required.
All iron supplements should be stored in a locked cupboard away from children. Iron overdose in a child can be fatal.
Prevention
A balanced diet after the age of 4-6 months, when solids are introduced, can prevent anaemia caused by not enough iron. Many health professionals suggest that babies under 12 months should avoid cows milk.
For more information on diet for your child, see your local maternal and child health nurse, doctor or dietitian.
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