ANEMIA

Definition: A condition of reduced red blood cells in the circulatory system.

Note: This is always a worrisome condition in childhood. Anemia can make children sluggish and decrease their capacity to perform. There is no reason why the cause of anemia cannot be fully established and appropriate treatment rendered if necessary.

1. What causes this condition to occur in my child?

Anemia occurs when there are not enough red blood cells to meet the needs of the child. Red blood cells carry oxygen to the various parts of the body. There are three reasons why a child may become anemic.

The first cause is bleeding. If the child is losing red blood cells from the body, whether it is from chronic nosebleeds or from bleeding in the gastrointestinal tract, eventually the red blood cell count will go down, and the child could become anemic.

     The second reason why a child may become anemic is if the body is unable to produce sufficient amounts of red blood cells. The most common reason in childhood is a lack of sufficient iron in the diet. This occurs most frequently in children between the ages of one and two who have had a diet made up primarily of cow’s whole milk. If the child is not getting sufficient iron in the diet, then the child is not able to make sufficient red blood cells. This can result in severe anemia. 

     The third reason why a child may become anemic would be if the red blood cells that the child produced do not survive in the body for a normal period of time. Normally, once red blood cells are made, the red blood cells will last in the body for approximately three months. There are a number of conditions that could cause the red blood cells to break down earlier than normal. In general, these are called hemolytic anemias. There are many different types of hemolytic anemia. Some types are inherited and are not correctable. Some types occur after certain viral illnesses and will eventually get better.

2. What tests are needed to better define the condition?

The first step is to measure the amount of hemoglobin and red cells in the body. Then, the physician or the laboratory technician will look at the red blood cells under the microscope. This will often give the physician a clue as to what is causing the anemia.

     The physician then might order a number of different tests to deter- mine the diagnosis. For instance, if the physician feels that the child may be losing blood, the physician may order special tests on the stool to look for any signs of blood. The physician also might want to measure the amount of iron in your child’s body. There are many tests that can better define the reasons for anemia.

3. How is it treated, and is it correctable?

The treatment for anemia depends on its cause. If the anemia is due to bleeding, then the cause for the bleeding must be determined, and corrective action will be taken. If the anemia is due to an insufficient amount of iron in the diet, then the patient will be placed on supple- mental iron, and often a change in diet is warranted. Some types of anemia are not correctable, though the most common forms of anemia are easily correctable.

4. Are there any potential side effects of the treatment?

There is always the possibility of side effects with any treatment, but in general, the treatment of anemia is well tolerated. Certain oral iron preparations may cause some temporary discoloration of the teeth or some belly pains or some constipation. Often, the physician can change the type of iron supplementation to meet your child’s needs.

5. What symptoms will my child have as a result of the condition?

In general, the symptoms of anemia are not seen in childhood until the anemia is fairly severe. The signs of anemia generally include fatigue and lack of energy.

6. Do we need to consult a hematologist (blood disorder specialist)?

Most pediatricians are able to diagnose and treat the more common causes of anemia in childhood. Sometimes the pediatrician will request a consultation from a pediatric hematologist for advice in treating anemia.

7. How often will my child need to be tested in the future to see if the condition is improving?

This depends on the cause of the anemia. If the anemia is due to iron deficiency, then the child will be tested several times in the first year or two to make sure that the condition is improving. In other cases of anemia, the scheduling for repeat testing will depend on the cause of the anemia.

8. When do you wish to see my child again regarding this disorder?

The frequency of visits to the doctor for the treatment of anemia will depend upon the cause of the anemia. In general, several trips to the doctor will be required in the first six months to a year if the anemia is due to iron deficiency. 

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