Anemia In Children: Causes, Symptoms And Treatment

Anemia in children is quite widespread in India. So, for parents, it's a must to know about the various causes of anemia, types of anemia, symptoms and treatment of anemia.

By Shirley Johanna

Anemia In Children: Causes, Symptoms And Treatment

Five-year-old Anamika, an active child, used to love playing with her friends and participating in school activities. But, when she started showing signs of fatigue and irritability, her mother, Ritu, got worried. She took Anamika to a paediatrician. After a thorough check-up, Anamika was diagnosed as suffering from nutritional anemia. This is a condition which is common among children under the age of five. However, the doctor assured Ritu that, with the right diet and treatment, Anamika would soon get better.

Anemia in children can manifest as tiredness, shortness of breath and dizziness. It can cause developmental delays and behavioural problems as well. Therefore, as a parent, it is crucial for you to know as much as you can about this condition to prevent your child from developing anemia.

What is anemia?

Anemia is a condition in which an individual suffers from low hemoglobin level. Iron, folic acid and vitamin B12 are the three main nutrients involved in the synthesis of haemoglobin. Deficiency of any of these three nutrients can cause anemia. However, iron deficiency is the most common cause of anemia worldwide.

How common is anemia?

According to the World Health Organization (WHO), globally, 1.62 billion people suffer from anemia. The highest prevalence of anemia (47.4 per cent) is among children under the age of five years; of these, a staggering 89 million children live in India.

Anemia in children

Toddlers and preschool children are more vulnerable to anemia. This is because, their body grows rapidly, and for this to happen, they require a nutritionally balanced diet. So, if your child is a toddler or a preschooler, and her diet is not rich in iron, she may be at risk of developing anemia. Generally, children with haemoglobin levels <11 g/dL are considered anemic.

Anemia adversely affects children’s cognitive performance as well as their language skills, motor skills and coordination. Anemia also has an impact on children's immune system, and increases the chances of infections and inflammatory diseases.

Causes of anemia in children

Anemia in children may be the result of one or several conditions like loss of red blood cells, destruction of red blood cells and the body's inability to produce red blood cells. Other common causes of anemia are infections, diseases and certain medications.

A diet that is deficient in iron, folic acid and vitamin B12 can also cause anemia in children. Children are born with some iron in their body. Once they are six months old and start on solid foods, there is a change in their iron intake pattern. The body demands extra iron to keep up with the rapid growth and development. Preschoolers are very active physically and they need an iron-rich diet on a daily basis. So, when the intake of iron is low, it could lead to anemia.

Symptoms of anemia in children

Anemia develops over time. When the amount of iron in the body goes below the normal level, children begin showing the following symptoms:

  • Pale skin
  • Tiredness and weakness
  • Irritability
  • Rapid heartbeat
  • Breathlessness
  • Dizziness
  • Loss of appetite
  • Slow growth rate

Types of anemia in children

The two most common types of anemia in children are iron deficiency anemia and hereditary anemia.

Iron deficiency anemia: This is a common form of anemia in preschoolers. It is caused by a decrease in the level of iron in the body. Iron facilitates the formation of haemoglobin. So, when the level of iron falls below normal, the haemoglobin level also decreases. This lead to the development of anemia in children.

Hereditary anemia: Some children are born with certain genetic abnormalities which can cause anemia. These genetic disorders can create red blood cells with a short life span or impair the production of haemoglobin. This can also give rise to anemia.

Treatment of anemia in kids

With advancement in medical science, most cases of anemia can be treated. However, the treatment differs according to the type of anemia.

Iron deficiency anemia: For children with iron deficiency anemia, the paediatrician may prescribe iron supplements to restore the depleted iron level. This is usually given for a minimum of three months. A nutritionist may also recommend a special diet comprising iron-rich foods.

Folic acid and vitamin B12 deficiency: Anemia caused by a lack of these two nutrients can be treated with folic acid and vitamin B12 supplements. However, this is rare in children.

Inherited blood disorders: In children with inherited blood disorders like sickle cell anemia, thalassemia, and aplastic anemia, bone marrow transplantation may be recommended.

Anemia caused by worm infection usually improves after the problem is treated. If the paediatrician suspects that certain medications could be causing anemia, he may recommend discontinuing the medicine or replacing it with another one.

Ailments caused by anemia

Anemia can lead to serious health problems if not dealt with at an early stage. It can affect the child’s cognitive development, and in severe conditions, might lead to permanent brain damage. Anemia also affects a child’s immunity, making him more prone to infections, slows down the growth process and decreases appetite.

Ways to prevent anemia

Anemia caused due to deficiency of iron, folic acid and vitamin B12 can be prevented by ensuring that the child eats a well-balanced diet. A child's diet should have all the nutrients necessary for her growth and development. Here's what a child's diet should always include:

Iron and vitamin C: At least one meal of the day should be rich in iron. Some of the foods rich in iron are dark green leafy vegetables, beans, meat, raisins, iron-fortified cereals, oatmeal, chicken, fish, egg yolk, peanut butter, tofu and sweet potatoes.

To accelerate the absorption of iron by the body, you can combine these with foods rich in vitamin C. This can boost the absorption of iron by up to three times. Vitamin C also helps in repairing red blood cells. Fruits such as strawberry, orange, banana, guava, kiwi, grape, lemon, beetroot, broccoli, cauliflower and tomatoes are commonly available sources of vitamin C.

Iron-rich recipe ideas: If your child is a fussy eater, then start with home-made juices and shakes. You can prepare mixed fruit juice, banana shake, strawberry shake or just plain fresh lime water. You can add chocolate syrup to change the colour of the preparation and make it look appealing. Try using citrus fruits more as they contain a lot of vitamin C.

Most children do not like eating vegetables. So, make a puree of one vegetable every day and mix it with rice while cooking or add it to the chapati dough. This method can ensure that you give your child adequate amount of iron without much struggle.

Another way of adding iron to your child’s diet is by giving iron-rich foods as finger food. You can give raisins, sweet potato cakes or fries, fish and chicken fingers, peanut butter sandwich and grilled tofu as snacks. This way your child will eat healthy and stay safe from anemia.

Other ways to prevent nutritional anemia:

  • Avoid giving cow’s milk to your baby until she is a year old. Cow’s milk may cause blood loss and decrease the absorption of iron.
  • If you prefer to give infant formula to your baby, ensure that the formula contains added iron.
  • For older children, make sure they eat iron-rich foods such as green leafy vegetables like spinach, egg yolk, lean meat, iron-fortified cereals, beans, walnuts, and pumpkin seeds.
  • To increase iron absorption, ensure your child consumes foods rich in vitamin C, like citrus fruits.

It is important to detect and treat anemia in children at the earliest, as it can affect a child’s growth and development. If your child begins to show symptoms of anemia, consult a paediatrician immediately.

About the author:

Written by Shirley Johanna on 1 September 2018; updated on 26 September 2019

The author is a nutritionist, aspiring teacher and a researcher who currently works as a copy editor at ParentCircle. She loves formulating nutritious recipes that can treat common nutritional deficiencies in children and adolescents.

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