Anemia in Kids: Causes, Symptoms, Diagnosis, and Treatment (2023)

Children can often appear tired or irritable, but when these symptoms become an ongoing problem, it could be a sign of something more serious.

Fatigue, pale skin, and even a bad mood can be signs of anemia — especially in babies who were born preterm, with low birth weight, or whose cords were clamped immediately after being born.

Anemia is the most common nutritional deficiency in the world, and anemia caused by iron deficiency and other problems can be concerning not only for the symptoms they cause but also for the long-lasting developmental effects that can follow.

This article will help you understand what anemia is and the different forms of this condition, as well as what to expect if your child develops anemia.

Anemia occurs when the number of red blood cells in a person’s blood is lower than normal or when the amount of hemoglobin in the red blood cells is too low.

Hemoglobin is a protein in your red blood cells that carries oxygen throughout your body and removes carbon dioxide. Low hemoglobin levels could mean that too little oxygen or too much carbon dioxide is in your body.

There are many ways anemia can develop. Below are some of the different types of anemia, and an explanation of how each causes symptoms.

Iron deficiency anemia

Iron is a mineral that your body needs in order to make hemoglobin. Low levels of iron — often from poor dietary intake — can decrease the amount and efficiency of hemoglobin in your body.

Iron-deficiency anemia is the most common type of anemia. Despite how common this condition is, many people don’t know they have iron-deficiency anemia and chalk their symptoms up to other causes.

Microcytic anemia

These types of anemias are defined by the size of your red blood cells. In people with microcytic anemia, red blood cells are smaller and paler than they should be. This indicates a decrease in their ability to transport oxygen.

While iron deficiency is a leading cause of this type of anemia, other causes can include:

  • acute or chronic bleeding
  • increased body demand for iron, such as during pregnancy
  • poor absorption of iron
  • trauma
  • surgery
  • heavy menstruation
  • cancers
  • some infectious diseases
  • inflammatory diseases

Determining the underlying cause for the specific type of microcytic anemia a person has is key to effective treatment.

Macrocytic anemia

Macrocytic anemias result from red blood cells that are too large. These larger red blood cells aren’t mature, so they don’t perform the same work as normal red blood cells.

Macrocytic anemias are split into two categories:

(Video) Anemia In Children - Causes, Symptoms and Treatment

  • Megaloblastic anemia: This occurs when the problem is caused by a DNA error in how your blood cells are produced.
  • Nonmegaloblastic anemia: This occurs when the cause is other factors like medications or lifestyle choices.

Megaloblastic anemias are often caused by things like:

  • vitamin B12 deficiency
  • folate deficiency
  • certain medications including chemotherapy

Nonmegaloblastic forms are caused by things like:

  • chronic alcohol use
  • liver disease
  • hypothyroidism

Hemolytic anemia

Hemolytic anemia is a type of anemia where your red blood cells are normal in size, shape, and function, but their lifespan is cut short.

Every cell type has a normal lifespan, but in hemolytic anemia, something causes your red blood cells to die off quickly or prematurely — and faster than they can be replaced.

Extrinsic hemolytic anemia is the name given to anemias in this category that are caused by some sort of malfunction that destroys your red blood cells. Examples include things like:

  • abnormal spleen function
  • autoimmune disease
  • tumors
  • infections
  • lymphomas
  • leukemias

Hemolytic anemias can also have an intrinsic cause, which develops because your red blood cells don’t function as they should. Examples include sickle cell anemia and thalassemia.

Sickle cell anemia

Sickle cell anemia is a type of intrinsic hemolytic anemia. With this form of anemia, red blood cells are C-shaped and become sticky and rigid. This abnormal shape makes these cells prone to becoming stuck in blood vessels, causing pain, tissue damage, and even blood clots.

Not all red blood cells are affected with the sickle shape, but it’s usually enough to produce noticeable symptoms of anemia. There are several forms of sickle cell anemia, but all are inherited genetic conditions that usually appear in the first few months of a child’s life.


Thalassemia is the name given to a group of blood disorders that affect the proteins that make up hemoglobin.

Hemoglobin is made up of two types of proteins — alpha and beta — and the type of thalassemia you have is determined by whether you’re deficient in alpha or beta proteins.

A deficiency in beta proteins creates the more severe type of thalassemia, often called thalassemia major or Cooley’s anemia. This form of the condition, due to a complete lack of beta proteins, creates a life threatening shortage of hemoglobin function that requires lifelong and regular blood transfusions.

Cooley’s anemia usually appears before the age of 2, and over time can cause complications because of iron buildup from so many blood transfusions.

Aplastic anemia

Aplastic anemia is a type of anemia where for one reason or another, your bone marrow just doesn’t produce enough red blood cells.

There are lots of things that can cause damage to bone marrow, and often the cause of this kind of anemia has multiple contributors or is unknown altogether.

Some possible contributors to aplastic anemia include:

  • chemotherapy
  • radiation
  • autoimmune disease
  • certain viruses like Epstein-Barr and HIV

What are the symptoms of anemia in kids?

(Video) Anemia, Causes, Signs and Symptoms, Diagnosis and Treatment

The symptoms of anemia in kids are similar to those in adults. But, depending on their age, they might have a hard time telling you how they feel.

Some of the most common symptoms seen in children who have iron-deficiency anemia include:

  • cough
  • stuffy nose
  • vomiting
  • diarrhea
  • abdominal pain
  • pale skin
  • irritability
  • pica
  • appearance of a neck mass
  • cellulitis
  • nosebleeds
  • blood in the stool
  • vomiting blood
  • cognitive or developmental problems

Other forms of anemia can present with a variety of symptoms, but the condition can also develop with no symptoms at all. In some cases, anemia might be diagnosed through blood work done for other purposes.

The cause of anemia depends on the type, but for many children, the condition is the result of an inherited or genetic condition that affects how red blood cells form or function.

Iron-deficiency anemia in infants and young children is usually linked to diet, due to a delay in introducing iron-fortified foods or iron supplements. Food allergies and other feeding difficulties can also contribute to the condition.

The main causes of microcytic anemias in children may also include:

  • infections
  • thalassemia
  • iron deficiency

Normocytic anemias in children are often caused by things like:

  • blood loss
  • autoimmune attacks on red blood cells
  • infections
  • iron deficiency
  • sickle cell disease
  • hemolytic diseases
  • bone marrow disorders
  • other red blood cell disorders

Macrocytic anemias in children are usually caused by problems that include:

  • congenital aplasia
  • vitamin B12 deficiency
  • folate deficiency
  • hypothyroidism
  • hypersplenism

It can be difficult to make a diagnosis of anemia in young children because symptoms can be mild or shared with a number of other conditions.

Your doctor will begin working on a diagnosis by asking about individual and family medical histories, other conditions, medications, diet, and development.

(Video) Anemia in Children: Diagnosis – Pediatric Hematology | Lecturio

A complete blood count (CBC) is a test done on a sample of blood taken in a lab, and it’s the most common diagnostic test for anemia. This test will give a count of all blood cell types in a sample.

Anemia can be diagnosed by comparing your child’s red blood cell count and hemoglobin level to normal ranges.

What’s a normal hemoglobin level?

Normal hemoglobin levels in children vary by age but can range from about 9 g per dL to 16.5 g per dL.

How anemia in children is treated will depend on:

  • how severely anemic your child is
  • the type of anemia
  • any underlying conditions contributing to the problem

Iron-deficiency anemia is the most common type of anemia in children and is usually treated with iron supplementation and diet changes. If iron supplements are required, your doctor will recommend a specific formulation and dosing based on your child’s age and level of iron deficiency.

In milder cases, or alongside supplementation, your doctor may also suggest increasing the amount of iron-fortified or iron-rich foods in your child’s diet. This can include foods like:

  • red meat
  • seafood
  • poultry
  • eggs
  • iron-fortified cereals
  • beans and lentils
  • dark green, leafy vegetables

In addition to adding iron-rich foods to your child’s diet, it’s also helpful to increase iron absorption in the body by pairing these with vitamin C-rich foods like:

  • citrus fruits
  • berries
  • papaya
  • tomatoes
  • sweet potatoes
  • broccoli
  • cabbage
  • dark green, leafy vegetables

In cases of severe anemia or certain types, such as Cooley’s anemia, your child may require blood transfusions or other ongoing treatments.

What are the risk factors for anemia in kids?

(Video) Anemia - Causes, Symptoms, Treatments & More…

There are several forms of anemia that are inherited or run in families, so a family or parental history of anemia can indicate a certain level of risk.

Beyond that, a number of factors can increase the risk of developing anemia. These include:

  • prematurity
  • low birth weight
  • early cord clamping after birth
  • early introduction of cow’s milk (before at least 1 year of age)
  • blood loss due to trauma or surgery
  • long-term illness or infection
  • nutrition deficiency or malnutrition

Symptoms of anemia in children may go unnoticed, or even be chalked up to normal growth cycles. Be sure to discuss your child’s diet and the recommended amounts of iron your child requires at routine well visits.

If you see any signs of severe bleeding, fatigue, or lethargy, visit or call your pediatrician or healthcare professional.

Iron-deficiency anemia is the most common form of this condition among young children, and it’s usually treated through diet and supplementation.

In most cases, anemia is a short-term, treatable condition. In some cases, however, children with certain other forms of anemia may require ongoing medical treatment to maintain their blood counts and prevent complications like organ failure.

Anemia in children can appear as fatigue, paleness, irritability, or even cognitive problems.

(Video) Iron-Deficiency Anemia (Overview) | Causes, Pathophysiology, Signs & Symptoms, Diagnosis, Treatment

In most cases, anemia in kids can be attributed to iron deficiency. Diet changes and supplementation can help. More severe cases — especially with specific genetic causes of anemia — may require ongoing care and treatment, which includes regular blood transfusions.

If you think your child has iron deficiency or anemia, talk with your pediatrician. They can do blood testing and provide guidance on treatment.


What is the main cause of anemia in children? ›

The most common causes include: nutritional deficiencies (iron, folic acid, or vitamin B12) inherited diseases (e.g., Fanconi anemia, thalassemia, sickle cell anemia) autoimmune diseases.

What are the causes of anemia in children and how do you treat it? ›

In most cases, anemia in kids can be attributed to iron deficiency. Diet changes and supplementation can help. More severe cases — especially with specific genetic causes of anemia — may require ongoing care and treatment, which includes regular blood transfusions.

How is anemia diagnosed in child? ›

How is iron-deficiency anemia diagnosed in a child? In most cases, anemia is diagnosed with simple blood tests. Routine anemia screening is done because anemia is common in children and they often have no symptoms. The AAP recommends anemia screening with a hemoglobin blood test for all infants at 12 months of age.

How is anemia treated in kids? ›

Doctors treat iron-deficiency anemia with iron supplements taken as a liquid or pill for at least 3 months. To help iron get absorbed into the body: Avoid taking iron with antacids, milk, or tea because these interfere with the body's ability to absorb iron.

Is anemia in children serious? ›

Iron deficiency in children is a common problem. It can occur at many levels, from a mild deficiency all the way to iron deficiency anemia — a condition in which blood doesn't have enough healthy red blood cells. Untreated iron deficiency can affect a child's growth and development.

What happens when a child is anemic? ›

Anemia is a condition in which the amount of red blood cells in the body is decreased below normal for your child's age. It can make your child appear pale in color and feel cranky, tired, or weak.

Can childhood anemia go away? ›

Most kinds of anemia are treatable. It may take a while for symptoms to go away, so your child should take it easy while recovering.

What is the most common childhood anemia? ›

Microcytic anemia due to iron deficiency is the most common type of anemia in children. The U.S. prevalence of iron deficiency anemia in children one to five years of age is estimated to be 1% to 2%.

Can anemia lead to leukemia? ›

Anemia and leukemia are both conditions that affect a person's blood. Although there is no evidence that anemia can cause leukemia, people with leukemia are more likely to develop anemia. This could be because leukemia, a form of blood cancer, causes anemia, which involves a reduction in red blood cells.

Which child is most at risk for anemia? ›

Toddlers and children of preschool age have the highest prevalence of anemia at 47.4% of their population group according to the World Health Organization (WHO), largely due to nutritional choices. Children require more iron for growth and development, yet many children receive less than their recommended daily value.

How common is childhood anemia? ›

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 doesn't 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.

When should a child be tested for anemia? ›

The Centers for Disease Control and Prevention recommends screening for iron deficiency anemia at ages 9 to 12 months, 6 months later, and then annually from ages 2 to 5 years in infants and preschool-age children who are at high risk for iron deficiency anemia.

What is the fastest way to cure anemia? ›

To treat your anemia, your doctor may suggest eating more meat—especially red meat (such as beef or liver), as well as chicken, turkey, pork, fish, and shellfish. Nonmeat foods that are good sources of iron include: Spinach and other dark green leafy vegetables.

What are signs of leukemia in a child? ›

What are the symptoms of leukemia in children?
  • Pale skin.
  • Feeling tired, weak, or cold.
  • Dizziness.
  • Headaches.
  • Shortness of breath, trouble breathing.
  • Frequent or long-term infections.
  • Fever.
  • Easy bruising or bleeding, such as nosebleeds or bleeding gums.

What is the danger of being anemic? ›

Severe iron deficiency anaemia may increase your risk of developing complications that affect the heart or lungs, such as an abnormally fast heartbeat (tachycardia) or heart failure, where your heart is unable to pump enough blood around your body at the right pressure.

What medication is used for anemia in children? ›

Methylprednisolone (Depo Medrol, Medrol, Solu-Medrol) This agent is used for initial management of acute hemolytic anemia. Intravenous methylprednisolone is recommended when the most rapid and reliable treatment of hemolytic anemia is required.

Is anemia serious if left untreated? ›

Left untreated, anemia can cause many health problems, such as: Extreme fatigue. Severe anemia can make you so tired that you can't complete everyday tasks. Pregnancy complications.

What is the main cause of anemia? ›

The most common cause of anemia is not having enough iron. Your body needs iron to make hemoglobin. Hemoglobin is an iron-rich protein that gives the red color to blood. It carries oxygen from the lungs to the rest of the body.

What is the number one symptom of anemia? ›

Fatigue — feeling too tired to manage your activities — is the most noticeable anemia symptom. Other symptoms may include: Shortness of breath (dyspnea): This is the feeling you can't catch your breath or take a deep breath. Dizziness: This is feeling lightheaded or unsteady on your feet.

What is pediatric anemia? ›

What is Pediatric Anemia? A child with anemia doesn't have enough red blood cells. These cells carry oxygen from the lungs to the rest of the body, enabling your muscles and organs to function properly. This lack of red blood cells can cause a child to feel weak and tired.

What cancers are associated with anemia? ›

The cancers most closely associated with anemia are: Cancers that involve the bone marrow. Blood cancers like leukemia, lymphoma, and myeloma interfere with or destroy the marrow's ability to make healthy blood cells. Other cancers that spread to the bone marrow can also cause anemia.

What cancers cause iron-deficiency anemia? ›

Iron deficiency anemia “may be the red flag that leads a health care provider to search for cancer,” says Francis, since it's typically caused by blood loss, which often occurs in colon cancer and uterine cancer but is less commonly in bladder cancer.

What will a hematologist do for anemia? ›

If you appear to have a form of aplastic anemia, your doctor may refer you to a hematologist for a bone marrow biopsy to determine the cause of the anemia. Medications and blood transfusions may be used to treat aplastic anemia.

What foods should be avoided in anemia? ›

Don't eat iron-rich foods with foods or beverages that block iron absorption. These include coffee or tea, eggs, foods high in oxalates, and foods high in calcium. Eat iron-rich foods with vitamin C-rich foods, such as oranges, tomatoes, or strawberries, to improve absorption.

What foods should an anemic person avoid? ›

Some foods can make it harder for your body to absorb iron. These include coffee, tea, milk, egg whites, fiber, and soy protein. Try to avoid these foods if you have iron deficiency anemia.

What drinks high in iron? ›

Iron-rich drinks include apple juice, apricot nectar, beef broth, beet juice, cocoa using natural cocoa powder, “green” smoothies, orange juice, pea protein smoothies, prune juice, tomato juice, and spinach juice.

What is the number one cause of anemia? ›

The most common cause of anemia worldwide is iron deficiency. Iron is needed to form hemoglobin, part of red blood cells that carry oxygen and remove carbon dioxide (a waste product) from the body. Iron is mostly stored in the body in the hemoglobin.

What are the three most common causes of anemia? ›

Anemia has three main causes: blood loss, lack of red blood cell production, and high rates of red blood cell destruction. Conditions that may lead to anemia include: Heavy periods.

What foods should I avoid with anemia? ›

Don't eat iron-rich foods with foods or beverages that block iron absorption. These include coffee or tea, eggs, foods high in oxalates, and foods high in calcium. Eat iron-rich foods with vitamin C-rich foods, such as oranges, tomatoes, or strawberries, to improve absorption.

What are the dangers of anemia? ›

Severe iron deficiency anaemia may increase your risk of developing complications that affect the heart or lungs, such as an abnormally fast heartbeat (tachycardia) or heart failure, where your heart is unable to pump enough blood around your body at the right pressure.

What diseases causes anemia? ›

Chronic conditions that cause anemia of inflammation
  • autoimmune diseases, such as rheumatoid arthritis link or lupus link.
  • cancer.
  • chronic infections, such as HIV/AIDS link and tuberculosis link.
  • CKD.
  • inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis.

What are three vitamin deficiencies that cause anemia? ›

Anemia is a term for these issues. Iron-deficiency anemia is the most common type, but low levels of folate or vitamin B-12 can also cause the condition, and a low vitamin C intake can contribute to it.

What is the symptoms of leukemia? ›

  • Fever or chills.
  • Persistent fatigue, weakness.
  • Frequent or severe infections.
  • Losing weight without trying.
  • Swollen lymph nodes, enlarged liver or spleen.
  • Easy bleeding or bruising.
  • Recurrent nosebleeds.
  • Tiny red spots in your skin (petechiae)
Sep 21, 2022

What age group is anemia most common in? ›

Anaemia is a serious global public health problem that particularly affects young children and pregnant women. WHO estimates that 42% of children less than 5 years of age and 40% of pregnant women worldwide are anaemic.


1. Hemolytic Anemia, Causes, Signs and Symptoms, Diagnosis and Treatment.
(Medical Centric)
2. What is Anemia ? Symptoms, Diagnosis, Treatment of Anemia.
(Hyunmi Bae)
3. Sickle cell anemia - causes, symptoms, diagnosis, treatment & pathology
(Osmosis from Elsevier)
4. Symptoms of Iron Deficiency Anemia in Children - On Call for All Kids
(Johns Hopkins All Children's Hospital)
5. Iron-deficiency Anemia: Signs and Diagnosis – Pediatric Nursing | Lecturio Nursing
(Lecturio Nursing)
6. Anemia - Causes, Symptoms, Treatments and Prevention
Top Articles
Latest Posts
Article information

Author: Kieth Sipes

Last Updated: 04/19/2023

Views: 5923

Rating: 4.7 / 5 (67 voted)

Reviews: 90% of readers found this page helpful

Author information

Name: Kieth Sipes

Birthday: 2001-04-14

Address: Suite 492 62479 Champlin Loop, South Catrice, MS 57271

Phone: +9663362133320

Job: District Sales Analyst

Hobby: Digital arts, Dance, Ghost hunting, Worldbuilding, Kayaking, Table tennis, 3D printing

Introduction: My name is Kieth Sipes, I am a zany, rich, courageous, powerful, faithful, jolly, excited person who loves writing and wants to share my knowledge and understanding with you.