Anaemia

Anaemia is most often caused by iron deficiency. Many babies and children get anaemia. See your doctor if your child looks very pale, is irritable and is very tired. Treatment for iron deficiency anaemia usually involves adding iron-rich foods to your child’s diet and giving iron supplements to help get your child iron levels back to normal.

What is anaemia?

Anaemia is when you don’t have enough red blood cells or when the blood cells don’t have enough haemoglobin.

There are many causes of anaemia.

Iron-deficiency anaemia

Anaemia most often happens because of a lack of iron, which your body needs to make haemoglobin. This type of anaemia is known as iron-deficiency anaemia.

Lack of iron in your child’s diet
Your child might get iron-deficiency anaemia if he isn’t getting enough iron from his diet.

In babies, this might happen if your baby is exclusively breastfed beyond six months of age. By around this age, your baby has used up all the iron stores she built up when she was in the womb. Your baby can’t get the iron she needs from breastmilk alone, because it’s a poor source of iron.

In older children, your child might get iron-deficiency anaemia if he:

  • drinks too much cow’s milk or drinks tea – these drinks reduce the absorption of iron from food.
  • doesn’t eat enough foods with iron
  • has a condition like coeliac disease, which stops him from absorbing iron from food very well.

Other causes of iron-deficiency anaemia
Iron deficiency anaemia can especially be an issue for babies:

  • who were born prematurely
  • who were very sick as newborns
  • whose mums were iron deficient during late pregnancy.

Iron deficiency can also be caused by blood loss. Children may lose blood in stool due to conditions in their bowels. Adolescent girls are at risk of iron deficiency anaemia if they have frequent, long or very heavy periods.

Anaemia caused by other deficiencies or problems

If your child isn’t getting enough vitamin B12 or folate from her diet, she might get anaemia.

Another cause of anaemia is haemolysis. This is when too many red blood cells are destroyed by the body. This situation could be due to genetuc diseases such as sickle cell anaemia or thalassaemia or to an infection.

Anaemia symptoms

If your child has anaemia, he might look very pale.

A toddler might get very tired. 

Your child might be cranky and hard to manage. Older children might be very tired, have a poor appetite and find it hard to concentrate at school.

 

When to see your doctor about anaemia symptoms

Take your child to the doctor if your child:

  • looks too pale
  • is irritable
  • doesn’t have much energy
  • complains of frequent headaches
  • isn’t putting on enough weight or is a fussy eater

Tests for anaemia

If the doctor thinks your child might have anaemia, the doctor will usually order blood tests to find the blood level of haemoglobin. 

There are referenrce tables with normal levels of haemoglobin for each age. 

Occasionally, other tests are indicated to identify the cause of the anemia.

Treatment for anaemia

Anaemia treatment depends on the cause.

If your child has anaemia caused by not enough iron, adding iron-rich foods to his diet can help boost his iron levels. Iron-rich foods include:

  • wholegrains and iron-fortified cereals
  • legumes – for example, lentils and beans
  • meat – for example, red meat, chicken and fish
  • egg yolk
  • dark green, leafy vegetables – for example, spinach
  • crushed sesame seeds – for example, tahini or halva.

Changing your child’s diet alone might not be enough. She might also need to take iron supplements (tablets or syrup) to help get her iron levels back to normal. Iron supplements can turn your child’s poo black or grey, and might cause constipation or tummy upsets. It’s a good idea to talk to your doctor about these and other side effects.

Very rarely, your child might need an infusion or injection of iron.

If the anaemia is caused by something other than iron deficiency, your child might need more tests and treatment. 

Preventing anaemia

Babies
When you’re introducing solid foods to your baby’s diet at around six months of age, it’s best to include plenty of iron-rich foods.

In many countries it is recommended to give to all babies aged 4-18 months daily iron solution to prevent  iron deficiency.

You can introduce pasteurised, unflavoured, full-fat cow’s milk to your baby’s diet after 12 months of age. But try to limit the amount of cow’s milk your child drinks to no more than 500 ml a day. 

Children and teenagers
As your child grows, offer him plenty of healthy, nutritious food from the five food groups. A balanced diet can help prevent anaemia caused by not enough iron, folate or vitamin B12. Keep limiting cow’s milk to no more than 500ml a day.