CHILDREN’S HEALTH: ANAEMIA

Anaemia occurs when there is too little hemoglobin in the blood. Hemoglobin is the substance that carries oxygen in the blood and gives the blood its red color. Normally, hemoglobin is contained within the red blood cells (RBCs). A child can be anemic because there are too few RBCs, because each RBC contains too little hemoglobin, or as a result of both conditions.

There are more than 30 types of anaemia, each with its own cause and treatment. The most common is iron deficiency anaemia. Anaemia can occur at any age. Some forms run in families; others are acquired.

Among the most common causes of anaemia are a poor diet that does not include enough of the nutrients needed to manufacture hemoglobin (iron, protein, folic acid, vitamin Bi2, and copper); the loss of blood by internal or external bleeding; a failure to absorb nutrients, even though they are eaten; the formation of abnormal (short-lived) RBCs; an inability of the bone marrow to produce RBCs fast enough; and the too-rapid destruction of normal RBCs within the body. In addition to the many diseases that are forms of anaemia, many other illnesses can produce anaemia.

Signs and symptoms

Most cases of anaemia produce no symptoms. However, tiredness, shortness of breath, rapid pulse, and jaundice (yellowing of the skin and the whites of the eyes) may be clues. If a child looks pale, check the nail beds, the inside of the eyelids, and the membranes inside the mouth for additional colorlessness. Also watch for these possible causes of anaemia: vomiting of blood; blood in the stools (red or tarry-black bowel movements); excessive menstruation; a grossly inadequate diet; chronic diarrhea; and exposure to poisonous substances.

If you think your child might have anaemia, see your doctor. The presence and type of anaemia can only be determined by laboratory tests. Periodic examinations and a medical history taken by a doctor can help detect anaemia early, an important factor in treatment. If one family member has anaemia, watch for symptoms in other family members.

Home care

Never attempt to treat anaemia yourself. The wrong treatment can be harmful and will make a proper medical diagnosis difficult. All children should receive a balanced diet to prevent anaemia caused by lack of proper nutrition.

Precaution

Iron overdosing is the second most common poisoning among children in this country. If iron supplements are prescribed by your doctor, keep them out of the reach of children. Some iron medicines are sweet, and children might mistake them for candy.

Medical treatment

To evaluate your child for anaemia, the doctor will give your child a physical examination, take a medical history, and test for simple total blood count. Your doctor may also need to take a reticulocyte (young RBC) count, platelet (a blood element that aids in clotting) count, and measurements of iron and of the iron-binding capacity in the blood. More extensive testing, if necessary, will include hemoglobin electrophoresis, sickle cell test, urinalysis, test of stools for hidden blood, examination of bone marrow, test for poisons, examination of the child’s parents’ blood, X ray of the intestinal tract, and blood chemistries. These tests will determine the type of anaemia.

The treatment prescribed may include adding supplementary iron and vitamins to the diet, a change in diet, and-though rarely-a blood transfusion. Iron or vitamin injections also are rarely called for and, if given, are administered for the first one or two doses only.

As treatment proceeds, be sure additional tests are scheduled to check on the effectiveness of the treatment. The proof of proper treatment is in the cure.

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