Anemia (continued)

Treatment

Treatment for anemia depends on its cause. It's important not to assume that any symptoms your child may be having are due to iron deficiency. Be sure to have your child checked by a doctor.

If your child has iron deficiency anemia, the doctor may prescribe medication as drops (for infants) or as a liquid or tablet (for older kids), which usually must be taken for as long as 3 months to rebuild the body's store of iron. The doctor also may recommend adding certain iron-rich foods to your child's diet or reducing milk intake.

If your teenage daughter is anemic and has heavy or irregular menstrual periods, her doctor may prescribe hormonal treatment to help regulate the bleeding.

Folic acid and vitamin B12 supplements may be prescribed if the anemia is traced to a deficiency of these nutrients, although this is rare in children.

Anemia caused by an infection will usually improve when the infection passes or is treated. If a certain medication appears to be the cause, your doctor may discontinue it or replace it with something else — unless the benefit of the drug outweighs this side effect.

Depending on the cause, treatment for more severe or chronic forms of anemia may include:

• transfusions of normal red blood cells taken from a donor
• removal of the spleen or treatment with medications to prevent blood cells from being removed from circulation or destroyed too rapidly
• medications to fight infection or stimulate the bone marrow to make more blood cells

In some cases of sickle cell anemia, thalassemia, and aplastic anemia, bone marrow transplantation may be used. In this procedure, bone marrow cells taken from a donor are injected into the child's vein; they then travel through the bloodstream to the bone marrow and begin producing new blood cells.

Caring for a Child With Anemia

The type, cause, and severity of your child's anemia will determine what kind of care is needed. Rest assured, though, that kids often tolerate anemia much better than adults.

In general, a child with significant anemia may tire more easily than other kids and therefore need to limit activity levels. Make sure that your child's teachers and other caregivers are aware of the condition. If iron deficiency is the cause, follow the doctor's directions about dietary changes and taking any iron supplements.

If the spleen is enlarged, your child may be prohibited from playing contact sports because of the risk that the spleen could rupture or hemorrhage if your child is hurt. Certain forms of anemia, such as sickle cell anemia, require other more specific kinds of care and treatment.

Preventing Anemia

Whether anemia can be prevented depends on its cause. Currently, there is no way to prevent anemia due to genetic defects affecting the production of RBCs or hemoglobin.

However, you can help prevent iron deficiency, the most common form of anemia. Before following any of these suggestions, be sure to talk them over with your doctor:

• Cow's milk consumption. During the first 6 months of life, babies are usually protected against developing iron deficiency by the stores of iron built up in their bodies before birth. But after month 6, they often don't get enough iron through breast milk alone or regular cow's milk (which contains less iron than fortified infant formula). Regular cow's milk can cause some infants to lose iron from their intestines, and drinking lots of it can make a baby less interested in eating other foods that are better sources of iron. For these reasons, regular cow's milk is not recommended for children until they reach 1 year of age and are eating an iron-rich diet. In addition, they should not drink more than 24-32 ounces (709-946 ml) of milk each day. If you can't get your child to eat more iron-rich foods, speak with your doctor about giving your child an iron supplement.
• Iron-fortified cereal and formula. These products can help ensure that your baby is getting enough iron, especially during the transition from breast milk or formula to solid foods.
• Well-balanced diet. Make sure that your kids regularly eat foods that contain iron. Good choices include iron-fortified grains and cereals, red meat, egg yolks, leafy green vegetables, yellow vegetables and fruits, potato skins, tomatoes, molasses, and raisins. If your child is a vegetarian, you'll need to make an extra effort to ensure sufficient iron sources because iron found in meat, poultry, and fish is more easily absorbed than iron found in plant-based and iron-fortified foods. Also, be aware that certain food combinations can inhibit or promote absorption of iron. For example, drinking coffee or tea (including iced tea) with a meal can significantly lower the amount of iron absorbed. On the other hand, vitamin C helps the body absorb iron.

If you have any questions about anemia or you think your child might have it, speak with your doctor.

Reviewed by: Robin E. Miller, MD
Date reviewed: April 2009