What to Know About Anemia in Kids

Medically Reviewed by Renee A. Alli, MD on April 23, 2023
4 min read

Anemia is a common condition in kids, affecting about 20% of children in the U.S. Anemia occurs when a child doesn’t have enough red blood cells or hemoglobin (a type of protein that allows red blood cells to carry oxygen to cells throughout the body).

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.

Your child might have anemia if their body:

Doesn't produce enough red blood cells. If they don't have enough iron or other nutrients in their typical diet, this can happen.

Destroys too many red blood cells. When a child has inherited a red blood cell disorder like sickle-cell anemia (when a protein called hemoglobin inside the red blood cells forms chains that clump together and cause the red blood cell to be shaped like a crescent moon or the letter C ― called a sickle cell) or an underlying illness, this can happen.

Loses red blood cells through bleeding. This can occur as long-term, low-grade blood loss, sometimes in their stool. It can also happen when there is significant blood loss, such as heavy menstrual bleeding.

There are a few different types of anemia:

  • Iron deficiency anemia. When there isn’t enough iron in the blood.
  • Megaloblastic anemia. This occurs when the red blood cells are too large from a lack of folic acid or vitamin B-12.
  • Hemolytic anemia. When red blood cells are destroyed, typically due to serious infection or certain medications.
  • Sickle cell anemia. An inherited type of anemia where the child has abnormally shaped red blood cells.
  • Cooley's anemia (thalassemia). A different inherited form of anemia with abnormal red blood cells.
  • Aplastic anemia. When the child’s bone marrow fails to make blood cells.

Some risk factors for anemia in kids include:

  • Premature birth or low birth weight
  • Living in poverty or inability to afford foods rich in iron
  • Consuming cow’s milk at an early age (toddlers can develop iron deficiency anemia if they drink too much cow's milk) or excessive consumption at the appropriate age
  • Diet low in iron, vitamins, or minerals
  • Surgery or accident with blood loss
  • Infections
  • Kidney or liver disease
  • Family history of inherited anemia, most commonly sickle cell anemia

The most common symptoms of anemia in kids include:

  • Increased heart rate
  • Trouble catching their breath or breathlessness
  • Lack of energy, getting tired easily
  • Dizziness when standing
  • Headache
  • Irritability
  • Sore, swollen tongue
  • Yellowing eyes, skin, and mouth
  • Enlarged spleen or enlarged liver
  • Delayed growth and development
  • Poor wound and tissue healing

Anemia is often a symptom of another disease. If you suspect your child has anemia, make an appointment with your child’s doctor right away. 

Your doctor can help diagnose anemia by doing a screening and some blood tests. They will often:

  • Ask questions about your child’s symptoms
  • Ask about your child’s diet
  • Ask if any family members have anemia
  • Complete a physical exam for your child

Your doctor may also run blood tests and look at red blood cells under a telescope to check on their shape and size, check the amount of hemoglobin and iron in the blood, and check for possible anemias.

To complete these tests, your doctor will place a needle into your child’s skin to remove blood. Depending on the results of the blood test, your doctor may refer you to a specialist called a hematologist to conduct tests on your child’s bone marrow.

Bone marrow is the spongy part inside the bone where blood cells are made. The doctor inserts a needle into the bone, taking a small sample to examine in a lab.

After your doctor gains a better understanding of what’s causing your child to experience anemia, they can help create a treatment plan. 

Treatment will depend on your child’s symptoms, age, health, and severity of the anemia.

Some types of anemia do not require treatment. However, other types of anemia may require medicine, blood transfusions, surgery, or stem cell transplants. In some cases, your child's healthcare provider may refer you to a hematologist. This is a specialist in treating blood disorders.

The most common treatment options for anemia in kids include:

  • Vitamin and mineral drops or pills
  • Iron supplements
  • A change in your child's diet
  • Stopping a medicine that’s causing anemia
  • Medicine
  • Surgery to remove the spleen
  • Blood transfusions
  • Stem cell transplants

If your child’s anemia is related to iron deficiency or nutritional deficiency, you can help prevent it by making sure that your child eats a well-balanced diet.

Avoid giving your baby cow’s milk. Wait until your baby is at least 12 months old before giving them cow’s milk. Consuming cow's milk before your child is ready can decrease the amount of iron absorbed in their gut and may cause blood loss in their stool. Once they are 1 year of age, limit milk intake to 16 -20 ounces daily to ensure an adequate variety of foods daily.

If you’re breastfeeding, your baby will have an adequate iron supply until at least 4 months of age. At 4 months of age, breastfed infants should be given iron supplements until they are eating enough iron-rich foods.

If you’re feeding your baby formula, use a baby formula fortified with iron.

Feed your child an iron-rich diet. Milk can make kids feel full and is low in iron, which may decrease the likelihood that they’ll eat other foods rich in iron. Good sources of iron include beans, egg yolks, molasses, potatoes, tomatoes, raisins, and red meat.

Should your child have an inherited red blood cell disorder, a pediatric hematologist will help you manage their symptoms and provide your child with supportive care.