More About Anemia in Children

Anemia is a common problem in children. About 20% of children in the U.S. will be diagnosed with anemia at some point. A child who has anemia does not have enough red blood cells or hemoglobin. Hemoglobin is a type of protein that allows red blood cells to carry oxygen to other cells in the body.

There are many types of anemia. Your child may have one of the following:

  • Iron deficiency anemia. Too little iron in the blood. Iron is needed to form hemoglobin. This is the most common cause of anemia. 
  • Megaloblastic anemia. Red blood cells are too large. One type of megaloblastic anemia is pernicious anemia. In this type, there is a problem absorbing vitamin B12, important to making red blood cells.
  • Hemolytic anemia. Red blood cells are destroyed. There are many different causes, such as serious infections or certain medications.
  • Sickle cell anemia. An inherited type of anemia with abnormally shaped red blood cells. It is a type of hemolytic anemia.
  • Cooley's anemia (thalassemia). Another inherited type of anemia with abnormal red blood cells.
  • Aplastic anemia. Failure of the bone marrow to make blood cells.

Because anemia is common in children, doctors do routine screening for it. Plus, it often has no symptoms. Most anemia in children is diagnosed with these blood tests:

  • Hemoglobin and hematocrit. This is often the first screening test for anemia in children. It measures the amount of hemoglobin and red blood cells in the blood.
  • Complete blood count, or CBC. A complete blood count checks the red and white blood cells, blood clotting cells (platelets), and sometimes, young red blood cells (reticulocytes). It includes hemoglobin and hematocrit and more details about the red blood cells.
  • Peripheral smear. A small sample of blood is examined under a microscope to see if they look normal.

To get a blood sample, a healthcare provider will insert a needle into a vein, usually in the child's arm or hand. A tourniquet may be wrapped around the child's arm to help the healthcare provider find a vein. Blood is drawn up into a syringe or a test tube. In some cases, blood can be taken using a needle prick.

Blood tests may cause a little discomfort while the needle is inserted. It may cause some bruising or swelling. After the blood is removed, the healthcare provider will remove the tourniquet, put pressure on the area, and put on a bandage.

Depending on the results of the blood tests, your child may also have a:

  • Bone marrow aspiration, biopsy, or both. This involves taking a small amount of bone marrow fluid (aspiration) or solid bone marrow tissue (called a core biopsy). The fluid or tissue is examined for the number, size, and maturity of blood cells and/or abnormal cells. 

Anemia has 3 main causes:

  • Loss of red blood cells
  • Inability to make enough red blood cells
  • Destruction of red blood cells

Decreased red blood cells or hemoglobin levels may be due to:

  • Inherited red blood cell defects
  • Infections
  • Some diseases
  • Certain medicines
  • Lack of some vitamins or minerals in the diet
Call your child's healthcare provider if you notice that your child has any of the symptoms of anemia. And, if your child has not been checked for anemia, talk with the provider about your child's risk of getting it.