What is anemia?

Anemia is a common blood disorder that occurs when there are fewer red blood cells than normal, or there is a low concentration of hemoglobin in the blood.

  • Hemoglobin  is the part of blood that distributes oxygen from the lungs to tissues in the body.
  • Hematocrit is the measurement of the percentage of red blood cells found in a specific volume of blood.

Anemia is often a symptom of a disease rather than a disease itself. Anemia usually develops due to the presence of one of the following:

  • Excessive blood loss or hemorrhaging
  • Deficient production of red blood cells
  • Excessive red blood cell destruction
  • Both decreased production and excessive destruction of red blood cells

There are many different types of anemia, including:

Signs and symptoms

Most symptoms of anemia are a result of the decrease of oxygen in the cells or "hypoxia." Because red blood cells (as hemoglobin) carry oxygen, a decreased production or number of these cells result in "hypoxia." Many of the symptoms will not be present with mild anemia, as the body can often compensate for gradual changes in hemoglobin.

Each child may experience symptoms of anemia differently. Symptoms may include:

  • Abnormal paleness or lack of color of the skin
  • Increased heart rate (tachycardia)
  • Breathlessness, or difficulty catching a breath (dyspnea)
  • Lack of energy, or tiring easily (fatigue)
  • Dizziness, or vertigo especially when standing
  • Headache
  • Irritability
  • Irregular menstruation cycles
  • Absent or delayed menstruation (amenorrhea)
  • Sore or swollen tongue (glossitis)
  • Jaundice, or yellowing of skin, eyes, and mouth
  • Enlarged spleen or liver (splenomegaly, hepatomegaly)
  • Slow or delayed growth and development
  • Impaired wound and tissue healing

The symptoms of anemia may resemble other blood disorders or medical problems. Because anemia is often a symptom associated with another disease, it is important for your child's physician to be aware of symptoms your child may be experiencing. Always consult your child's physician for a diagnosis.


Generally, anemia may be caused by several problems, including the following:

  • Infection
  • Certain diseases
  • Certain medications
  • Poor nutrition

Testing and diagnosis

Diagnosing anemia begins with a complete medical history and physical examination of your child. Your child's physician may order additional diagnostic procedures including:

  • Blood tests to measure the concentration of hemoglobin and the number of red blood cells in your child's blood
  • Bone marrow aspiration and/or biopsy, a procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.


Specific treatment for anemia will be determined by your child's physician based on the following:

  • Your child's age, overall health, and medical history
  • The extent of the anemia
  • The type of anemia
  • Cause of the anemia
  • Your child's tolerance for specific medications, procedures or therapies
  • Expectations for the course of the anemia
  • Your opinion or preference

Anemia can be challenging to treat because the condition — and what causes the disorder — differs from child to child. Treatments may include:

  • Vitamin and mineral supplements
  • Change in your child's diet
  • Medication and/or discontinuing causative medications
  • Treatment of the causative disorder
  • Surgery to remove spleen (if related to hemolytic anemia)
  • Blood transfusions, if necessary (to replace significant loss)
  • Antibiotics (if infection is causative agent)
  • Bone marrow transplant (for aplastic anemia)

Next Steps