Anemia in children

 60_65% of Indian children suffer from anemia. One of the main blood illnesses, anemia, results from the body having fewer red blood cells than usual. Hemoglobin is a protein that enables red blood cells to carry oxygen all over the body.  Anemia develops when there is shortage of either RBC cells or the protein.

Anemia is often a symptom of another disease or condition rather than a disease on its own. It can sometimes be temporary and result from blood loss or an inadequate diet. However, for many people, it is caused by an ongoing or chronic condition, such as cancer, autoimmune disorders, or genetic defects, among others. While many types of anemia are mild and easily treatable, some can be severe, chronic, and potentially life-threatening.

What is anemia in children?

Anemia in children occurs when the body either destroys, loses, or produces too few red blood cells. This is pretty common in toddlers and teenagers because the need for iron and other nutrients increases asgrowth is rapid.

Anemia in children may result from genetic conditions, poor diets low in iron or vitamin B12, infections, some cancers, and a few medical treatments.

Anemia in children : Sickle Cell

There are several types of anemia

Iron deficiency anemia: This occurs when there isn’t enough iron in the blood, which is needed to produce hemoglobin. It’s the most common type of anemia.

Megaloblastic anemia: This happens when red blood cells are too large due to a lack of folic acid or vitamin B-12. One form of this is pernicious anemia, where the body has trouble absorbing vitamin B-12, which is crucial for making red blood cells.

Hemolytic anemia: This means that the red blood cells are destroyed prematurely. Severe infections and certain medications cause this to happen.

Sickle cell anemia: This is generally an inherited form of anemia, whereby the red blood cells involved are abnormally shaped and malfunctioned.

Cooley’s anemia (thalassemia):A blood disorder characterized by lower-than-normal amounts of an oxygen-carrying protein. Thalassemia is an inherited blood disorder characterized by less oxygen-carrying protein and fewer red blood cells in the body than normal.

Aplastic anemia: This occurs when the bone marrow fails to produce enough blood cells. A plastic anemia develops due to damage to the bone marrow. The damage may be present from birth or occur due to exposure to radiation, chemotherapy, toxic chemicals, some drugs, or infections.

Fanconi anemia (FA):It is an extremely rare and unique genetic disorder, characterized by a large number of physical anomalies and associated with bone marrow failure and predisposition to the development of cancer.

Diamond-Blackfan anemia (DBA):Diamond–Blackfan anemia is a congenital, usually infantile, erythroid aplasia. DBA causes low red blood cell count without substantially changing other blood components that are usually normal.

Causes of Anemia in Children

Anemia in children can have three basic causes:

Loss of Red Blood Cells: It is because of bleeding or any other cause.

Inability to Produce Enough Red Blood Cells: This can result from various conditions affecting the bone marrow or other processes.

Destruction of Red Blood Cells: Any disease or disorder can lead to the destruction of red blood cells. 

Low counts of red blood cells or hemoglobin levels can be caused by:

• Genetic defects related to red blood cells
• Infections
• Some medical conditions
• Certain medications
• Too little of certain vitamins or minerals in the diet

Children at risk for anemia:

• Being born prematurely or with a low birth weight
• Living in poverty or coming from a developing country
• Consuming excessive amounts of cow’s milk
• Having a diet deficient in iron or certain vitamins and minerals
• Experiencing blood loss due to surgery or accidents
• Chronic diseases or infections such as infections or diseases of the kidneys and liver
• Family history of inherited anemias such as sickle cell anemia 

Anemia in children : Causes, Symptoms, Diagnosis, Treatment and Complications

Symptoms of anemia in a child

The symptoms of anemia in children appear due to the lack of an adequate supply of oxygen delivered to the cells. Mild anemia may not show many symptoms, but it has the following symptoms and signs such as:

• Rapid heartbeat
• Short breath/breathing difficulties
• Feeling weak/becoming tired easily
• Feeling lightheaded or dizzy, particularly when standing up from a seat
• Headaches
• Irritability
• Irregular or absent menstrual periods
• Sore or swollen tongue
• Pale skin
• Yellowish discoloration called jaundice
• Enlarged spleen or liver
• Slowed growth and development
• lowered immunity ,making the child  prone to infections
• Poor wound healing

These symptoms can also be related to other blood disorders or health issues.

 Diagnosis of Anemia in a child

Anemia in children is usually diagnosed by these blood tests:

• Hemoglobin and Hematocrit: This is an initial test that gives the levels of hemoglobin and the number of red blood cells in blood to detect anemia.
• Complete Blood Count: This test provides more information on red and white blood cells, platelets, and sometimes the immature red blood cells. It comprises measures of haemoglobin and hematocrit but gives more details on the red blood cells.
• Peripheral Smear: A small sample of blood is taken and examined under the microscope to identify any abnormalities in the blood cell’s appearance.

Treatment of Anemia in a child

Treatment of anemia in a child depends on the cause. Some kinds of anemia don’t need treatment, while others may need different types of treatments, such as medication, blood transfusions, surgery, hematopoietic stem cell transplants. The doctor treating your child may refer you to a hematologist. This is a doctor who specializes in blood disorders.

Treatment that may be recommended for your child includes:

• Vitamin and mineral supplements
• Dietary changes
• Stopping medicines that can cause anemia
• Blood transfusions
• Hematopoietic Stem cell transplants
• Surgery to remove the spleen, in some cases

 Complications of anemia in a child

Possible complications of anemia in a child may involve:

• Growth and developmental problems
• Joint pain and swelling
• Failure of bone marrow
• Increased risk for leukemia or other cancers

 What are some of the measures to prevent anemia in children?

Help your child avoid becoming anemic by making sure they consume adequate iron in their diet. Even though some anemias are inherited and thus unavoidable, iron deficiency anemia can be prevented by the following:

1. Exclusive Breastfeed:Your breast milk provides sufficient iron until around 6 months of age. After 6 months, introduce an iron supplement.
2. Choose an iron-fortified formula: If you’re using a formula, opt for one that is enriched with iron.
3. Avoid cow’s milk before age 1: Cow’s milk lacks sufficient iron and can interfere with iron absorption. It’s best to introduce it only after your child is 1 year old and has a varied diet. Excessive cow’s milk can also inhibit iron absorption.
4. Include iron-rich foods: Once your child starts eating solid foods, offer iron-rich options such as iron-fortified cereals, egg yolks, red meats, potatoes, tomatoes, and raisins

Conclusion

The underlying cause determines the overall prognosis for the long-term outlook of children with anemia. Anemia due to nutritional deficiency can often be resolved quickly and may not require ongoing care. However, if anemia is due to a genetic condition or a serious underlying disorder, your child might require ongoing monitoring by a hematologist. Your child’s doctor will be able to provide details about the specific care plan needed.