Anemia in Children and Teens: Parent FAQs

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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. Though these symptoms may worry you, the most common causes of anemia―such as iron deficiency―are generally easy to treat, especially when it is detected early. In addition, parents need to be aware of the steps to take to prevent this condition.

Because rapid growth is a potential cause of the condition, the first year of life and adolescence are two age groups where infants and children are especially prone to anemia.

What is anemia?

Anemia means there are not enough red blood cells in the body. Red blood cells are filled with hemoglobin, a special pigmented protein that makes it possible to carry and deliver oxygen to other cells in the body. The cells in your child’s muscles and organs need oxygen to survive, and decreased numbers of red blood cells can place stress on the body.

Your child may become anemic if his or her body:

• 
  Does not produce enough red blood cells. This can happen if she does not have enough iron or other nutrients in her diet (e.g. iron-deficiency anemia).

• 
  Destroys too many red blood cells. This type of anemia usually happens when a child has an underlying illness or has inherited a red blood cell disorder (e.g.
  sickle-cell anemia).

• 
  Loses red blood cells through bleeding. This can either be obvious blood loss, such as heavy menstrual bleeding, or long-term low-grade blood loss, perhaps in the stool.

What are the common signs and symptoms of anemia?

• Pale or sallow (yellow) skin
• Pale cheeks and lips
• Lining of the eyelids and the nail beds may look less pink than normal
• Irritability
• Mild weakness
• Tiring easily, napping more frequently
• Children experiencing red blood cell destruction may become jaundiced (yellowing of the skin or eyes) and have dark tea or cola-colored urine

Children with severe anemia may have additional signs and symptoms:

• Shortness of breath
• Rapid heart rate
• Swollen hands and feet
• Headaches
• Dizziness and fainting
• Restless leg syndrome

When kids eat non-foods: 

​Children with anemia caused by very low levels of iron in their blood may also eat strange non-food things such as ice, dirt, clay, paper, cardboard, and cornstarch. This behavior is called “pica” (pronounced pie-kuh). Pica often occurs in children who are low in iron and can cause constipation. In these children, the pica usually stops after the anemia is treated with iron supplements. 

If your child shows any of these signs or symptoms, please see your pediatrician.

Even a low level of anemia can affect your child’s energy, focus, and ability to learn. Chronic iron deficiency anemia can result in long term, permanent impairment of development. In most cases, a simple blood count can diagnose anemia.

How can I prevent my child from becoming anemic?

Iron-deficiency anemia and other nutritional anemias can be prevented by ensuring that your child eats a well-balanced diet. Talk with your doctor about any specific dietary restrictions in your household as your child
may require a nutritional supplementation to prevent anemia. 

How can I manage anemia if my child has an inherited red blood cell disorder?

Your pediatrician will likely refer you to a
pediatric hematologist to provide you with supportive care and education on your child’s specific condition.

Remember:

If your child starts to show any signs or symptoms of anemia, be sure to tell your pediatrician. Also, find out if anyone in your family has a history of anemia or problems with easy bleeding. With proper treatment, your child’s anemia should improve quickly.

Additional Information:

• Pump Up the Diet with Iron

• 
  Vitamin D & Iron Supplements for Babies: AAP Recommendations 

​

Last Updated

1/24/2019

Source

AAP Section on Hematology/Oncology (SOHO) ＆ AAP Committee On Nutrition (CON) (Copyright © 2019)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Folate-Deficiency Anemia | Johns Hopkins Medicine

What is folate-deficiency anemia?

Folate-deficiency anemia is the lack of folic acid in the blood. Folic acid is a B vitamin that helps your body make red blood cells. If you don’t have enough red blood cells, you have anemia.

Red blood cells carry oxygen to all parts of your body. When you have anemia, your blood can’t bring enough oxygen to all your tissues and organs. Without enough oxygen, your body can’t work as well as it should.

Low levels of folic acid can cause megaloblastic anemia. With this condition, red blood cells are larger than normal. There are fewer of these cells. They are also oval-shaped, not round. Sometimes these red blood cells don’t live as long as normal red blood cells.

What causes folate-deficiency anemia?

You can develop folate-deficiency anemia if:

• You don’t eat enough foods that have folic acid. These include green leafy vegetables, fresh fruits, fortified cereals, yeast, and meats (including liver).
• You drink too much alcohol
• You have certain diseases of the lower digestive tract, such as celiac disease. This type of anemia also occurs in people with cancer.
• You take certain medicines, such as some used for seizures.
• You are pregnant. This is because the developing baby needs more folic acid. Also, the mother absorbs it more slowly. A lack of folate during pregnancy is linked to major birth defects that affect the brain, spinal cord, and spine (neural tube defects).

Some babies are born unable to absorb folic acid. This can lead to megaloblastic anemia. With this condition, red blood cells are larger than normal. They also have a different shape. Early treatment is needed to prevent problems such as poor reasoning and learning.

Who is at risk for folate-deficiency anemia?

You are more likely to have this type of anemia if you:

• Don’t eat a healthy diet
• Drink a lot of alcohol
• Are pregnant
• Can’t absorb folic acid
• Are taking certain medicines, such as those used to control seizures

What are the symptoms of folate-deficiency anemia?

Symptoms may include:

• Pale skin
• Decreased appetite
• Being grouchy (irritable)
• Lack of energy or tiring easily
• Diarrhea
• Smooth and tender tongue

The symptoms of folate-deficiency anemia may look like other blood conditions or health problems. Always see your healthcare provider for a diagnosis.

How is folate-deficiency anemia diagnosed?

Your healthcare provider may think you have this type of anemia after taking your medical history and doing a physical exam. You may have several blood tests to confirm the diagnosis. You may also have a barium study if a digestive problem is the cause.

How is folate-deficiency anemia treated?

Your healthcare provider will figure out the best treatment based on:

• Your age, overall health, and medical history
• How sick you are
• How well you can handle certain medicines, treatments, or therapies
• How long the condition is expected to last
• Your opinion or preference

Treatment may include:

• Vitamin and mineral supplements
• Changes in your diet
• Medicine
• Treating the underlying disease

You may need to take folic acid supplements for at least 2 to 3 months. These may be pills or shots (injections). Eating foods high in folic acid and cutting your alcohol intake are also important. If a digestive tract problem causes your anemia, your provider may treat that first.

What are the complications of folate-deficiency anemia?

Folate-deficiency anemia during pregnancy may cause a neural tube defect. This is when the brain or spinal cord doesn’t develop normally. It can cause death before or soon after birth. Or it may cause paralysis of the legs.

Key points about folate-deficiency anemia

• Most folate-deficiency anemia is caused by a lack of folic acid in the diet.
• Leafy vegetables, citrus fruits, beans, and whole grains are natural sources of folic acid.
• Folate-deficiency anemia in pregnancy may cause a neural tube defect. This is when the brain or spinal cord doesn’t develop normally.
• Treatment includes a well-balanced diet of foods with folic acid, folic acid supplements, medicines, and treating underlying diseases.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Anemia in a dog: symptoms, causes, treatment

Anemia in a dog reduces the number of red blood cells and hemoglobin in the blood. The supply of organs and tissues with oxygen is disrupted. Because of this, the pet may die. Read our article and find out how to save a dog with anemia.

A few words about anemia

Anemia is a state of the body in which the number of red blood cells (erythrocytes) and the hemoglobin protein contained in them decreases. Hemoglobin and erythrocytes are associated with providing the cells of the body with oxygen. Therefore, with anemia, hypoxia (oxygen starvation) occurs.

It must be remembered that anemia is only a symptom of certain diseases. It occurs in all dogs, regardless of breed or age. Therapy of anemia is aimed at eliminating its symptoms. However, the main task of the veterinarian is to determine the underlying disease that caused anemia and cure it.

Let’s talk more about anemia in dogs.

Causes and factors that cause anemia in dogs

Anemia in dogs appears for the following reasons:

• Internal and external bleeding as a result of injuries, operations, inflammatory processes
• Infectious and parasitic diseases
• Diseases of the internal organs
• Autoimmune diseases

• Chemical poisoning, drugs
• Infestation with internal and external parasites
• Oncological diseases

The causes of anemia in dogs are varied. We have only mentioned the common ones. Also, some animals have a genetic predisposition to the disease.

What types of anemia do dogs have

The classification of anemia is quite complicated. It is based on the causes of anemia, the ability of the bone marrow to recover, changes in the shape and structure of red blood cells. Determining the type of anemia helps the veterinarian choose the right treatment for your pet. In clinical practice, the following classification is most often used:

• Anemia due to blood loss (posthemorrhagic)
• Anemia due to destruction of erythrocytes (hemolytic)
• Anemia due to impaired production of red blood cells and hemoglobin in the bone marrow
• Mixed anemias

Let’s talk more about the main types of anemia that are most common in dogs.

Hemolytic anemia in a dog

Hemolytic anemia in dogs can be congenital or acquired. Congenital occurs due to the presence of hereditary defects in red blood cells. Acquired hemolytic anemia develops when exposed to chemicals, microorganisms, parasitic protozoa, poisoning, liver disease, transfusion of incompatible blood.

Posthemorrhagic anemia

Posthemorrhagic anemia occurs in acute and chronic forms. In acute posthemorrhagic anemia, there is a rapid loss of a significant amount of blood. This is observed with injuries, gastric or intestinal bleeding, during surgical operations. In the absence of obvious injuries, it is necessary to exclude the presence of hidden bleeding using ultrasound, gastroscopy and laboratory tests.

Chronic anemia develops as a result of constant blood loss due to diseases of the gastrointestinal tract, infection with helminths, flea bites.

Hypoplastic form of anemia

Hypoplastic anemia is associated with a deficiency in the dog’s body of micro and macro elements, vitamins. And also when the bone marrow is damaged by toxins.

Aplastic anemia in a dog

This form of anemia develops due to impaired hematopoietic function. The formation of red blood cells and other blood cells worsens.

Mixed anemias are due to a combination of two or more causes. Such anemias are more difficult to diagnose and treat.

Symptoms of anemia in a dog

Anemia impairs the supply of oxygen to the body’s cells. Therefore, the owner may observe the following symptoms in the dog:

• Pale or bluish tinge of mucous
• Apathy, lethargy
• Decreased activity
• Fatigue
• Rapid pulse and breathing

If anemia is associated with heavy bleeding, symptoms appear quickly. If the condition is caused by other causes, then the symptoms appear slowly. The owner of the dog often does not suspect that the pet has health problems.

Disease diagnosis. What tests will the veterinarian prescribe?

The main method for diagnosing anemia in a dog is a clinical blood test.

However, the main thing for the doctor is to find out what caused this condition in the pet. The following tests will come to the aid of a veterinary specialist:

• Biochemical blood test
• Blood smear testing for parasitic protozoa
• Fecal parasite and occult blood test

• Bone marrow biopsy
• Endoscopy
• Tests for genetic diseases

Only after determining the underlying disease, the doctor prescribes an effective treatment that will defeat anemia.

Treatment of anemia in a dog. Anemia medications

There is no single treatment for anemia in dogs. The doctor prescribes drugs and procedures based on the condition of the pet:

• Intravenous infusions of solutions to increase blood volume
• Transfusion of blood and its components
• Antibiotic therapy for infectious diseases

• Course of vitamins and preparations containing macro- and microelements
• Antiparasitics
• Bone marrow transplant

During the treatment it is necessary to control the condition of the pet. With the right therapy, good care and feeding, the dog recovers in a couple of months. In the chronic form of anemia, maintenance therapy is prescribed.

Prevention of anemia. Proper diet for your pet

To prevent anemia in your dog, take the following preventive measures:

• Visit your veterinarian regularly
• Vaccinate the animal in a timely manner
• Feed your dog properly. Use quality foods rich in vitamins and minerals. The pet’s menu should contain meat and meat products, offal (required liver), buckwheat. With natural nutrition, enter vitamin and mineral supplements into the dog’s diet. When choosing an industrial diet, give preference to high-quality feed from trusted manufacturers.

• Give medicines only after consultation with a veterinarian
• Keep your pet away from poisonous substances
• Treat your dog regularly for external and internal parasites

Regular parasite treatment

Fleas, ticks, helminths and other parasites cause significant harm to the health of the pet and can provoke the development of anemia in him. Protecting a pet from infection is an important task that the owner faces.

To save time and budget, many dog ​​owners and breeders use the IN-AP complex, which in one application will rid your four-legged friend of external and internal parasites.

Use IN-AP complex against external and internal parasites

IN-AP complex is a preparation in the form of drops on the withers for the treatment and prevention of infection with external and internal parasites in cats. The drug acts in a complex and destroys parasites at different stages of development:

• Bloch
• Lice and lice
• Ixodid ticks
• Roundworms and tapeworms

For IN-AP prophylaxis, use the complex at intervals of 6-7 weeks. Use the drug strictly according to the weight of the animal. If several animals live in the house, carry out preventive treatment at the same time.

We wish your pet good health!

What do you need to know about anemia?

Anemia, the most common blood disease, is caused by low hemoglobin levels in the blood. Almost always, with this disease, the content of red blood cells also decreases in the blood.

Anemia is often the result of other diseases that interfere with the body’s ability to produce healthy red blood cells, or that abnormally increase the loss or breakdown of red blood cells.

Physicians estimate that the disease now affects more than 1.6 billion people worldwide – about a quarter of the world’s population.

• Children at preschool age are most at risk for anemia. According to WHO estimates, the prevalence of anemia in this population group is 47.4%, that is, 293 million children worldwide have anemia.
• More than 400 types of anemia have been identified.
• Anemia is not limited to humans, it can affect cats and dogs.

The most common symptoms of all types of anemia are feeling tired, weak and tired.

Also characteristic symptoms are:

• pale skin
• palpitations and palpitations
• shortness of breath and shortness of breath
• chest pains
• headache
• fainting
• tinnitus

Mild anemia may show little or no symptoms.

Some forms of anemia may have specific symptoms:

Aplastic anemia – fever, frequent infections and skin rashes

Folate deficiency anemia – irritability, diarrhea and varnished tongue

Hemolytic anemia – jaundice, dark urine, fever and abdominal pain

sickle cell anemia – painful swelling of the arms and legs, fatigue and jaundice

To live, the body needs red blood cells that carry hemoglobin, a complex protein containing iron molecules. These molecules, in turn, distribute oxygen from the lungs throughout the body.

A low red blood cell count can be caused by a variety of conditions.

There are many types of anemia, but there is no single cause for this disease. The exact cause is sometimes difficult to determine.

Below are the causes of the three main groups of anemia.

1. Anemia due to blood loss

The most common type of anemia, iron deficiency anemia, is often included in this category because iron deficiency is caused by blood loss.

Due to the loss of blood, water from the tissues quickly enters the bloodstream – in this way the body tries to maintain the volume of blood in the blood vessels. As a result, the blood is diluted, and the percentage of red blood cells, respectively, decreases.

Blood loss can be rapid and acute or chronic.

Acute blood loss may be due to surgery, childbirth, trauma, or a ruptured blood vessel.

In cases of anemia, chronic blood loss is more common, which can be caused by gastric or duodenal ulcers, cancers, tumors.

Anemia due to blood loss can also be caused by:

• hemorrhoids,
• gastritis,
• use of non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, etc. ),
• menstrual bleeding.

2. Anemia caused by a decrease in the production of red blood cells or the production of defective red blood cells.

This anemia is characterized by inhibition or cessation of growth and maturation in the bone marrow of all blood cells – the bone marrow produces stem cells that develop into red blood cells, white blood cells and platelets.

This effect on the bone marrow can be caused by a number of diseases, including leukemia, a disease that produces too many abnormal white blood cells, which in turn interferes with the normal production of red blood cells.

Anemia due to a decrease in red blood cell production can develop due to exposure to: chemicals (arsenic, salts of heavy metals), ionizing radiation, drugs, viruses (eg, hepatitis viruses, Epstein-Barr virus) and as a result of autoimmune processes.

Anemias caused by low RBC production or defective RBCs also include:

• Sickle cell anemia. Due to a genetic defect, the formation of normal hemoglobin chains in red blood cells is disrupted. The abnormal hemoglobin formed in this case differs in its electrophysiological properties from the hemoglobin of a healthy person, as a result of which the erythrocytes themselves change, acquiring an elongated shape, resembling a crescent moon under a microscope. These deformed cells can clog small blood vessels, causing pain, severe complications, and even death.
• Iron deficiency anemia – lack of iron necessary for the normal synthesis of hemoglobin. The reason may be poor nutrition, menstruation, frequent blood donation, diseases of the gastrointestinal tract (gastritis, colitis, Crohn’s disease, surgical removal of part of the intestine). An imbalance in the flow and intake of iron can be caused by an increased need of the body due to pregnancy, chronic diseases that provoke hypoxia or are accompanied by purulent-necrotic processes.
• Vitamin deficiency anemia. It is caused by a deficiency in the body of vitamins necessary for the production of red blood cells, such as folic acid and B12. Deficiency of these vitamins occurs when their absorption in the gastrointestinal tract is disturbed, which may be due to helminthic invasion, inflammatory diseases of the stomach and intestines, and dysbacteriosis.

Vitamin-deficiency anemia can also be caused by genetic abnormalities that cause a violation of the metabolism of vitamins necessary for blood formation.

3. Anemia caused by the destruction of red blood cells (hemolytic anemia)

Normally, red blood cells have a lifespan of 120 days in the bloodstream, but they can be destroyed or removed early.

One type of anemia that falls into this category is autoimmune hemolytic anemia, where the body’s immune system mistakenly identifies its own red blood cells as a foreign substance and attacks them.

Excessive hemolysis (breakdown of red blood cells) can occur for many reasons, including:

• infections
• medicines (eg some antibiotics)
• snake or spider venom
• toxins produced by the kidneys or liver due to disease
• autoimmune aggression (e. g. due to hemolytic disease)
• severe hypertension
• vascular grafts, prosthetic heart valve
• blood clotting disorders
• enlargement of the spleen

Treatment

There are a number of treatments for anemia, all of which involve increasing the number of red blood cells. Treatment also depends on the type of anemia.

• Iron deficiency anemia: iron supplements or dietary changes. If the anemia is due to blood loss, the bleeding must be found and stopped.
• Vitamin deficiency anemia: dietary supplements and vitamin B12 injections.
• Thalassemia: folic acid supplements, spleen removal, in some cases blood transfusion and bone marrow transplant.
• Anemia due to chronic disease: no specific treatment, focus on the underlying disease.
• Aplastic anemia: blood transfusion or bone marrow transplant.
• Sickle cell anemia: oxygen therapy, pain management and intravenous drugs. Treatment may also include antibiotics, folic acid supplements, and blood transfusions. Western medicine also uses the anticancer drug hydroxyurea (trade names Droxia, Hydrea).
• Hemolytic anemias: Patients should avoid certain medications and are prescribed immunosuppressants and treatment for infections. In some cases, plasmapheresis may be required.

Risk factors

Anemia can occur in anyone, regardless of gender or age. However, some factors increase the risk of the disease. These factors include:

• menstruation
• pregnancy and childbirth
• premature birth
• age 1 to 2 years
• food low in vitamins, minerals and iron
• loss of blood due to surgery or trauma
• diseases such as AIDS, diabetes, kidney disease, cancer, rheumatoid arthritis, heart failure and liver disease
• a family history of hereditary anemia such as sickle cell anemia
• intestinal disorders

Disease prognosis

The prognosis depends on the cause of the anemia – many cases of anemia can be prevented or treated with just a change in diet.

Some types of anemia can last for a long time, and some, if left untreated, can be life-threatening.

Anyone who is constantly feeling weak and tired should see a doctor for anemia.

Diagnosis

The most common method for diagnosing anemia is a complete (clinical) blood test (CBC).

CBC, as a rule, includes from 8 to 30 items: counting the number of erythrocytes, leukocytes, platelets in 1 microliter or liter of blood, as well as a number of other indicators that describe the shape, volume and other characteristics of these cells.

CBC is used for general health assessment, it can indicate the presence of diseases such as leukemia or kidney disease.

If the levels of red blood cells, hemoglobin and hematocrit are below normal, anemia is likely. However, KLA is not a guarantee of a definitive diagnosis. In this case, additional studies are assigned.

Remember: only a qualified specialist can make an accurate diagnosis and prescribe treatment!

For anemia, you can contact the Professor’s Clinic: at ul.