Anemia in Babies

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Anemia is a condition that results when the body doesn't have enough healthy red blood cells, which are responsible for carrying oxygen to the body’s tissues. Anemia may occur in newborns and in older babies and can affect older children and adults, too. Your little one could be anemic for a number of reasons. Read on to learn about the causes of anemia, what the signs and symptoms are, and what will happen if your baby has anemia.

What Is Anemia?

To help explain anemia, let's begin with a little background on blood cells. Blood is made up of different kinds of cells, almost half of which are red blood cells. These cells contain a red pigmented protein called hemoglobin. The job of hemoglobin is to carry oxygen to tissues in the body and carry away carbon dioxide, which is a waste material. Anemia results when there’s not enough hemoglobin in the red blood cells, or when there are not enough healthy red blood cells, to transport oxygen throughout the body. This can cause problems with cell function and growth.

Causes of Anemia in Newborns and Babies

Some of the causes and risk factors of anemia in newborns and older babies include the following:

  • Not enough red blood cells are produced. This is frequently due to an iron deficiency, which can occur when young babies start drinking cow's milk too early (cow's milk has very little iron and shouldn’t be introduced before the age of 1). In rare cases, another nutritional deficiency could be the issue, such as a lack of folic acid.

  • Too many red blood cells get destroyed. This may happen when a child has a condition like hemolytic anemia or sickle cell anemia, which is most common in those of African heritage.

  • The red blood cells don’t contain enough hemoglobin. Inherited blood disorders such as thalassemia, often seen in those of Asian, African, Middle Eastern, Greek, and Italian heritage, can lead to not enough hemoglobin or even a low number of red blood cells.

  • The body has lost blood. This can result from an injury or from a condition such as hemophilia, in which the blood doesn't clot properly.

  • Lead poisoning. Babies and toddlers might chew on objects that contain lead, such as paint chips or toys painted with lead, or may be exposed to air or water contaminated with lead.

What Are the Signs and Symptoms of Anemia in Babies?

  • Pale skin

  • Lips, lining of the eyelids, and nail beds looking less pink than normal

  • Irritability

  • Weakness

  • Tiring easily or napping more than usual

  • Yellow skin and/or eyes (jaundice)

  • Dark-colored urine.

Signs of severe anemia can include:

  • Shortness of breath

  • A rapid heart rate

  • Swelling of the hands and feet

  • Headaches

  • Dizziness and fainting.

Your baby’s anemia may be due to an iron deficiency. This type of anemia commonly affects babies between 9 and 24 months. The following are some of the signs and symptoms of anemia due to an iron deficiency:

  • Decreased appetite

  • Irritability

  • Fussiness

  • Inattentiveness

If you notice any of the above signs and symptoms in your child, or you think they may not be getting enough iron in their diet, consult their healthcare provider.

What Is the Treatment for Anemia in Babies?

Because there are many different kinds of anemia with different treatments, it’s best to follow your child’s healthcare provider’s advice on how to treat your baby's anemia. Don’t give your baby vitamins, supplements, or any other over-the-counter medication without first getting your provider’s OK.

To treat your baby’s anemia, the healthcare provider may recommend medications, dietary restrictions, or supplements. If the anemia is due to a lack of iron, the provider may prescribe a medication for iron in liquid drop form.

The provider may want to see your baby periodically to check iron levels. It's important that your little one is getting just the right amount of iron supplementation and not too much. Do not stop giving your baby the iron medicine unless your provider has told you it’s no longer needed.

If it’s determined that your baby’s anemia is due to a blood cell disorder like hemolytic anemia, sickle cell anemia, or thalassemia, their provider may recommend taking your child to a hematologist, a doctor who specializes in blood conditions.

If your newborn was born prematurely or if your baby is very ill, in some cases, their healthcare provider may recommend a blood transfusion to treat the anemia.

How Do You Prevent Anemia in Babies?

Not all types of anemia can be prevented, especially those that are due to genetic conditions such as sickle cell anemia or thalassemia. However, anemia caused by an iron deficiency or another nutritional deficiency can be prevented by adhering to a well-balanced diet. Here are some ways that you may be able to prevent nutritional anemia in your baby:

  • Don’t give your baby cow’s milk until they’re at least 12 months old.

  • If your baby is breastfed, your healthcare provider may start them on an iron supplement at about 4 months old, in most cases continuing supplementation until complementary solids have been introduced (at about 6 months) that are high in iron, such as iron-fortified cereals and pureed meats.

  • If your baby is formula-fed, choose a baby formula that has added iron. Avoid low-iron formula.

  • After your baby has turned 12 months old, feel free to introduce cow’s milk, but don’t offer more than 2 cups per day. Milk is low in iron and anything more than that can cause your baby to feel full, and therefore less likely to eat iron-rich foods.

  • Once your baby is accustomed to eating solids, opt for providing them a well-rounded diet, including iron-rich foods like red meat, egg yolks, potatoes, tomatoes, beans, dried fruit, and dark, leafy greens.

  • Include foods rich in vitamin C, as this vitamin helps with iron absorption. Foods high in vitamin C include citrus fruits, orange juice, peppers, tomatoes, spinach, and broccoli.

The Bottom Line

In most cases, anemia can be treated effectively either with changes in your little one’s diet or with medicine or supplements provided by their healthcare provider. If the anemia is due to a genetic condition, your baby’s healthcare provider can refer you to a specialist for treatment options.

If you ever suspect your baby may be anemic and you’ve noticed some signs and symptoms of anemia, like lethargy or pale skin, consult your baby’s healthcare provider, who can run a simple blood test to check their hemoglobin levels.

With a diagnosis in hand, your baby’s provider will be able to recommend the right course of action. Sooner than you know it, your little one will be back to the picture of health.

How We Wrote This Article

The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.

How We Wrote This Article The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.


About Christopher B. Peltier

Dr. Chris Peltier is an expert in pediatrics and medical education, and currently practices as a general pediatrician at Pediatric Associates of Mount Carmel, Inc., where he’s served his community for over two decades. Dr. Peltier currently serves as...

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