Anemia is a common disorder for many children and adults. For those diagnosed with anemia, symptoms such as fatigue, dizziness, and rapid heartbeat may be common concerns.

Anemia is a blood disorder that occurs when there is a deficiency of healthy red blood cells in the body. Blood consists of both liquid (plasma) and three types of cells. The white blood cells help the body fight off infections, whereas the platelets help blood clot in order to stop bleeding, and the red blood cells help to transport oxygen to organs and tissues.

The red blood cells house an iron-rich protein known as hemoglobin, which is responsible for transporting oxygen to various parts of the body. To produce this necessary element, the body needs ample supplies of iron and protein. Such supplies come from food, vitamin supplements, or blood cells that are recycled by the body.

Regardless of the cause, if a person loses a large volume of blood, experiences a decrease in the production of red blood cells, or has experienced a depletion of existing red blood cells, he or she will suffer from anemia.

What Is Anemia

There are several types of anemia. The most commonly occurring types of anemia are nutritional-based, including iron deficiency anemia and vitamin deficiency anemia when a lack of iron and vitamins in the diet contributes to the anemia.

With iron deficiency anemia, the most common form of anemia in the U.S., the body does not produce enough iron and, therefore, cannot produce the hemoglobin necessary to transport oxygen to the tissues and organs.

Vitamin deficiency anemia is similar in that it caused by a lack of nutrients--in this case, folate and vitamin B-12. But with this particular form of anemia, the body slows its red blood cell production and begins to produce large, abnormal red blood cells.

With both types of anemia, the outcome is the same--the body does not produce enough healthy red blood cells, and anemia is the result.

Anemia can cause the skin to be pale and may be most apparent as a decreased pinkness of the lips, the lining of the eyelids (conjunctiva) and the nail beds (pink part of the nails). Anemic children may act irritable, weak, or tired.

Children with severe anemia may have shortness of breath, rapid heart rate, and swelling of the hands and feet. If the anemia continues, it may interfere with normal physical and developmental growth.

Some types of anemia are more serious such as sickle cell anemia in which red blood cells take on an abnormal crescent shape. Sickle cell anemia causes early cell death and a chronic shortage of cells.

Sickle cell anemia is an inherited disorder, most common in people of African-American descent, and is not caused by problems in the diet.

Aplastic anemia, a life-threatening disorder in which the bone marrow is unable to produce any of the three types of blood cells, can be the result of chemotherapy, pregnancy, or a chronic disease such as lupus; however, it often is of unknown origin.

Some types of anemia can also be attributed to inherited disorders, exposure to cancer, or a toxin or drug interaction.

The American Academy of Pediatrics recommends that babies be screened for anemia between the ages of 9-12 months, with additional screening for children ages 1-5 who are considered at risk for the disorder.

To confirm that a person is anemic, health professionals typically order blood tests that allow them to determine the percentage of red blood cells and hemoglobin that make up the blood. The blood may also be examined under a microscope to evaluate the size, shape, and color of the blood cells.

Early detection is important because the symptoms can intensify with time and become more serious. A severe deficiency in iron also can impact a child’s development and physical growth. Further, blood work is important to help rule out other illnesses.

Deficiency-based anemia, such as that caused by a lack of iron or other vitamins, is most often treated through prescription iron supplements. Additional medication is typically not needed unless the symptoms are severe, such as an excessive loss of blood, weakness, feeling faint, or an extreme sense of mental confusion. The more serious forms of anemia often require medication and long-term treatment.

Children need to absorb an average of one mg. of iron per day to meet the needs of their growing bodies. Since children only absorb about 10 percent of the iron they eat, most children need to ingest 8-10 mg. of iron per day. Breast-fed babies need less iron intake as iron is absorbed three times better when it is in breast milk.

An iron poor diet is a common cause of iron deficiency anemia. Drinking too much cow’s milk can cause iron deficiency in young children, because cow’s milk does not contain iron. Milk is important in children’s diet, but should supplement, not replace, other iron-rich foods.

The following foods help boost iron levels in the body and are beneficial for all children, even those who are not anemic:

• green leafy vegetables;
• broccoli, green beans, lima beans, peas, asparagus;
• baked potatoes (with skins);
• eggs;
• beans and other legumes;
• meats, including red meat, poultry, and seafood;
• iron-fortified breads, rice, and cereals; and
• raisins, nuts, and seeds.

Drinking a glass of orange juice or other citrus juice when eating these iron-rich foods is helpful, as vitamin C aids in iron absorption. If a child in your care is anemic, it is important to follow the doctor’s recommendation for treatment. If you suspect that a child might be anemic, refer him or her to a health professional for evaluation and blood work. Early identification is important, as is the promotion of a healthy, iron-rich diet.

Diona L. Reeves
Consultant, American Academy of Pediatrics, Early Child Care & Education Initiatives

National Anemia Action Council, 555 E. Wells St., Ste.1100, Milwaukee, WI 53202; 414-225-0138; www.anemia.org

Keep Kids Healthy, www.keepkidshealthy.com/welcome/commonproblems/anemia.html

Children’s Hospital of Philadelphia, www.chop.edu/consumer/your_child/wellness_index.jsp?id=-8894

Kid’s Health, www.kidshealth.org/parent/medical/heart/anemia.html

University of Chicago, www.uchicagokidshospital.org/online-library/content=P02311