Anaemia is common in children, especially in the older baby and toddler age group.
Cause
There are three main causes of anaemia. By far the most common is a deficiency of iron in the body. Iron is essential for the formation of haemoglobin, the part of the red blood cell which carries oxygen around the bloodstream. Far less common causes are decreased production of red blood cells (aplasia — for example, in certain chronic diseases), or excessive destruction of red blood cells (haemolysis — for example, in some acute severe infections).
Iron deficiency in children is most often due to inadequate iron intake. Normally a baby has enough iron stores from his mother to last for the first 6 months of life, although if he was born prematurely or has been sick, the stores will be exhausted before then. After that he requires iron to be part of his diet. Usually at around 6 months of age, the baby is introduced to solids such as cereals, vegetables, eggs, and later on, meat, all of which contain iron. However, babies who are on cow’s milk and who drink excessive quantities often have insufficient iron in their diet. Cow’s milk is a poor source of iron, and in addition if a baby drinks too much milk his appetite for solids is diminished. This problem rarely occurs in breastfed babies, or those who are on formula feeds (because these contain iron).
Clinical features
The child with anaemia will appear very pale. A toddler may exhibit lethargy, but this may not be obvious, given his usual high energy levels. Some babies and toddlers with iron deficiency are irritable and difficult to manage. If the anaemia is caused by something besides iron deficiency, then specific features of that condition may be present.
Investigation are essential in any child with anaemia to find out its cause. Usually blood tests are all that is necessary, but sometimes other tests are performed as well.
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