Clinical Features, Causes, & Prevention Of Anemia In Children | Health


Anemia is defined as the reduction in the Red Blood Cells or Hemoglobin content of RBCs below that of normal limit for child’s age.

For e.g. – For a healthy child of the age 4 years, the normal level of hemoglobin is considered as 11.5 – 13.5 g/dl. The level below 11.5 g/dl is considered anemic.

Moreover, the severe anemia is when the level of hemoglobin fall down to less the 5 gm/dl while the level between 5-10 gm/dl is considered as moderate anemia.


The most important clinical manifestation is pallor of the skin and mucous membranes.

A very simple way to grade the severity of anemia is palmar pallor. If palms are pale but the creases in hands are pink, indicates moderate anemia. If the palm and creases are all pale, it usually means severe anemia.

There is another thing that may be commonly observed in children is that the behavior termed as “pica” which is a habit of eating strange things such as ice, dirt, clay, and cornstarch etc… it is not actually harmful but sometimes your child may eat something toxic or harmful for the health like lead powder or paint flakes. But don’t worry… your child will stop doing these things as he/she gets older.

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Some pediatrician believes that “pica” is an indication of iron deficiency so if your child showing this kind of habits kindly consult your pediatrician….

Other Signs and Symptoms are non-specific and include

  • Weakness
  • Tiredness
  • Irritability
  • Tachypnea
  • Shortness of breath on exertion

If your child shows any of these signs or symptoms, consult your pediatrician immediately. As the low level of anemia can directly affect your child’s energy, focus, and ability to learn new things.

Children with severe anemia may or may not have additional signs and symptoms:

  • Shortness of breath
  • Rapid heart rate
  • Swollen hands and feet
  • Congestive cardiac failure

Obviously, these symptoms may worry you but Anemia is usually easy to treat especially when it detected in early stage… Beside this, parents need to gain more n more information to prevent these or any kind of ailments that commonly arises in toddlers.


Anemia is not a disease in itself but it is an indication of underlying pathological processes or disease that occurs in the body.

Anemia may result from:

  • Impaired Production of Red Blood Cells. This condition is commonly observed in case of deficiency of Iron, Folic Acid, Vitamin B12, Zinc etc. and may be due to Bone marrow depression (Aplasia/ Hypoplasia).
  • Destruction of Red Blood Cells. This type of anemia is usually seen in children with some hereditary disorders like Thalassemia, Hereditary Spherocytosis, G6PD deficiency, Sickle cell anemia etc.
  • Loss of Red Blood Cells in Bleeding:- This may be physiological or pathological and commonly seen in children of age between 8-17 years which includes heavy menstrual bleeding or Chronic bleeding like in Hemorrhoids, Calculi in Urinary tract etc.

Classification of anemia in brief….

Anemia is most commonly classified on the size of the Red Blood Cells as

  • Microcytic (Small RBCs)
  • Normocytic (Normal RBCs)
  • Macrocytic (Large RBCs)

The size of the RBCs is measured by one of the values of Red Cell Indices which is Mean Corpuscular Volume (MCV) which is 75–100 fL (Femtoliters) in a healthy child.

Anemia is classified as Microcytic if MCV is less than 75 fL and Macrocytic if MCV is more than 100 fL.

Iron Deficiency and Thalassemia are the two most important and commonly observed causes of Microcytic Anemia in Children.

Macrocytic Anemia, if associated with Megaloblasts in the bone marrow, suggests the deficiency of Vitamin B12 or Folic Acid.

Macrocytic Anemia without Megaloblastic marrow is seen in Aplastic anemia.

Anemia of Chronic infections and those following Acute blood loss are Normocytic.

Check out the Red Cell Indices in Detail (MCH, MCV, and MCHC)


Here are some of the things that you must follow in order to save your child from anemia and also to manage n treat it if your child is suffering from any kind of anemia…

⇒ You can’t drink cow’s milk until you’re 12 months old… In the initial months, the infant’s gut is not so strong in order to digest heavy diets rich in protein, fat, and carbs which may cause blood loss in your child’s stool and also causes other disorders related to malabsorption.

⇒ I’m feeding you infant, don’t worry about your health….. I personally recommend that you must breastfeed your child at least for 6 months so that he/she will get proper nutrition. After that, if you continue the breastfeeding and also started giving some solid or semi-solid diet to your child, be sure that you must add some iron and nutritional supplements to it. For that, you can consult your pediatrician about foods and supplements that you should add in the diet.

⇒ Oh, girl/boy! You’re growing now; you need a more balanced nutrition rich diet….. Nowadays, you can easily get the information about nutritional values of any food you are going to buy, just check out the label of packets or containers to be sure that you are buying right kind of food and supplements for the proper growth and development of your child. Ideally, for growing children a diet rich in Vitamins, minerals, proteins, carbs, and fats should be given as per stated by your pediatrician.

⇒ See I am the C, Vitamin C; add me to your diet to get more from it…. Vitamin C helps greatly in the absorption of iron from the food via your gut. The Green leafy vegetables which are rich in iron commonly require vitamin C to get absorbed properly in your body. So you must give your child a diet that is rich in all the nutrition along with Vitamin C.

That’s all about Clinical features, causes, and Prevention of anemia in children

Further Reading:

Hemoglobin Level

Healthy Children


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