Anemia is a condition that often strikes without any outward manifestations, which could be why so many parents lose sleep over it. It's perceived as the hidden malady, slowly but constantly shaving away your child's intellect and physical potential.

The truth is that anemia is not as ominous as most parents fear. While chronic severe anemia can and does affect some children, most anemic children have a borderline blood count that does not pose a serious threat to their health.

Background and Definition

The red blood cells are responsible for carrying oxygen around the body. When your child's red blood cell concentration falls below a critical threshold, your child becomes anemic. The normal range for the concentration of red blood cells in the body varies according to the age of the child.

Newborn babies have a very high concentration of red blood cells because they needed to extract oxygen from the mother's blood before they were born. Once babies start to acquire oxygen using their own lungs, the additional blood cells are rendered redundant. The blood count quickly drops during the first month, but this is a normal phenomenon.

Over the next few months after birth, the baby's primary source of iron is either breast milk or commercial formulas. While these sources of iron are not completely sufficient to sustain growth indefinitely, they are adequate for the first six months of life. After six months, it is important for your baby to start taking some solid foods and obtaining additional sources of iron from her diet.

The blood-cell concentration reaches its lowest point at around six months of age. As the child grows, the blood count gradually rises until it reaches the peak level of an adult. During puberty, testosterone boosts the blood level of boys. As a consequence, the typical blood-cell concentration for a mature man is higher than a woman's. This gender discrepancy is not seen prior to adolescence.

During pregnancy, all women become relatively anemic. Not only does the baby steal iron from the mother's body, the increased water retention and blood volume during pregnancy dilute the existing blood cells so the concentration falls. This is the rationale behind iron supplementation during pregnancy. Fortunately, this mild degree of anemia does not usually cause any harm to the mother or the baby.

Manifestation of Anemia

Most children with mild anemia do not have any external visible findings. Many parents believe that white spots on the face or dry skin indicates the presence of anemia, but neither of these physical findings is related to anemia. The most common cause of these pale spots on the face is eczema, which is an allergic skin condition described in Chapter 10.

If significant anemia is present, the child may feel fatigued, experience headaches, or have breathing difficulties. Keep in mind that these symptoms do not manifest themselves until the concentration of red blood cells has fallen to a critically low level. You cannot always rely on these symptoms to detect anemia.

Since fatigue does not occur from anemia until the blood level is extremely low, it is not a common symptom of anemia. If your child experiences significant fatigue, there might be other potentially serious medical problems. Take your child to the doctor if he is unusually tired.

Causes of Anemia

Insufficient dietary intake of iron is by far the most common cause of anemia in children. This is why pediatricians emphasize the importance of a balanced diet. Another important cause of anemia is chronic intestinal bleeding. This is less common in children than adults, but its possibility must be considered when diagnosing and treating anemia. Other causes of anemia include rare inherited blood disorders, such as sickle cell anemia and thalassemia. The other causes are responsible for a very small fraction of anemic children.

Blood Tests for Anemia

Pediatricians regularly screen for anemia during routine well-child visits. The first anemia screen is usually done around one year of age, and once every two years is usually sufficient for healthy children over the age of two.

There are two ways to obtain blood samples when checking for anemia. The finger-prick method is fast and relatively painless, but it's not nearly as reliable as the blood sample taken from the vein directly. Doctors take all the factors into consideration when they select one method over the other.

Scheduled Bleeding

Adolescent girls who started menstruating at a young age are at a higher risk for developing anemia than their nonmenstruating peers and boys. Coupled with a less-than-desirable diet of junk foods and irregular eating habits, these young girls are especially susceptible to developing anemia.

If your daughter has heavy menstrual bleeding or frequent spotting, make sure she's eating enough meat and other iron-rich foods. If not, consider checking her for anemia annually.