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What is anaemia?

Anaemia is when you don't have enough red blood cells or when the blood cells don't have enough haemoglobin.

There are many causes of anaemia.

Iron-deficiency anaemia

Anaemia most often happens because of a lack of iron, which your body needs to make haemoglobin. This type of anaemia is known as iron-deficiency anaemia.

Lack of iron in your child's diet
Your child might get iron-deficiency anaemia if he isn't getting enough iron from his diet.

In babies, this might happen if your baby is exclusively breastfed beyond six months of age. By around this age, your baby has used up all the iron stores she built up when she was in the womb. Your baby can't get the iron she needs from breastmilk alone, because it's a poor source of iron.

In older children, your child might get iron-deficiency anaemia if he:

  • drinks too much cow's milk or drinks tea - these drinks stop iron from food being absorbed properly
  • doesn't eat enough foods with iron
  • has a condition like coeliac disease, which stops him from absorbing iron from food very well.

Other causes of iron-deficiency anaemia
Iron deficiency anaemia can be an issue for babies:

  • who were born prematurely
  • who were very sick as newborns
  • whose mums were iron deficient during late pregnancy.

Iron deficiency can be caused by blood loss. This means that adolescent girls are at risk of iron deficiency anaemia if they have frequent, long or very heavy periods.

Anaemia caused by other deficiencies or problems

If your child isn't getting enough vitamin B12 or folate from her diet, she might get anaemia.

Another cause of anaemia is haemolysis. This is when too many red blood cells are destroyed by the body. Haemolysis sometimes happens if your child has an infection.

Some children might get a type of inherited anaemia in which their red cells don't survive or work properly. Examples are sickle cell anaemia or thalassaemia.

Anaemia symptoms

If your child has anaemia, he might look very pale.

A toddler might get very tired. Because toddlers' energy levels go up and down, this can be hard to spot.

Your child might be cranky and hard to manage. Older children might be very tired, have a poor appetite and find it hard to concentrate at school.

If your child's anaemia is caused by something other than iron deficiency, she might show specific symptoms of this underlying cause. For example, children with anaemia caused by haemolysis might feel short of breath.

When to see your doctor about anaemia symptoms

Take your child to the GP if your child:

  • looks very pale
  • is irritable
  • doesn't have much energy
  • complains of frequent headaches
  • isn't putting on enough weight or is a fussy eater
  • drinks a lot of cow's milk.

Tests for anaemia

If the GP thinks your child might have anaemia, the GP will usually order blood tests to work out what's causing it.

Occasionally the results of these initial blood tests will show that your child needs some other tests. In this case, your child might need to see a paediatrician or a blood specialist (haematologist).

Quite often, children have blood tests for other conditions and anaemia shows up on the test results.

Treatment for anaemia

Anaemia treatment depends on the cause.

If your child has anaemia caused by not enough iron, adding iron-rich foods to his diet can help boost his iron levels. Iron-rich foods include:

  • wholegrains and iron-fortified cereals
  • legumes - for example, lentils and beans
  • meat - for example, red meat, chicken and fish
  • egg yolk
  • dark green, leafy vegetables - for example, spinach
  • crushed sesame seeds - for example, tahini or halva.

Changing your child's diet alone might not be enough. She might also need to take iron supplements (tablets or syrup) to help get her iron levels back to normal. Iron supplements can turn your child's poo black or grey, and might cause constipation or tummy upsets. It's a good idea to talk to your doctor about these and other side effects.

Very rarely, your child might need an infusion or injection of iron.

If the anaemia is caused by something other than iron deficiency, your child might need more tests and treatment. Your child will probably need to see a paediatrician or blood specialist.

All iron supplements should be stored in a locked cupboard away from children. Iron overdose in a child can be fatal.

Preventing anaemia

When you're introducing solid foods to your baby's diet at around six months of age, it's best to include plenty of iron-rich foods.

You can introduce pasteurised, unflavoured, full-fat cow's milk to your baby's diet after 12 months of age. But try to limit the amount of cow's milk your child drinks to no more than 500 ml a day. Using a cup instead of a bottle can help reduce the amount of cow's milk your child drinks.

Children and teenagers
As your child grows, offer him plenty of healthy, nutritious food from the five food groups. A balanced diet can help prevent anaemia caused by not enough iron, folate or vitamin B12.

Your child should avoid tea, and check with your health professional about giving your child herbal teas. Keep limiting cow's milk to no more than 500ml a day.

You can read more about choosing good food for children and teenagers in these articles:

  • Healthy food for babies and toddlers: the five food groups
  • Healthy food for preschoolers: the five food groups
  • Healthy food for school-age children: the five food groups
  • Nutrition and healthy food for teenagers

You can increase iron absorption from food by eating vitamin C-rich foods at the same time as iron-rich foods. Vitamin C-rich foods include citrus fruits and strawberries.