Anaemia in Babies

When your body cannot produce enough healthy red blood cells, which are responsible for transferring oxygen to the tissues, it leads to a condition called anaemia. Anaemia is common in newborns and older babies, but it can also affect older children and adults. There are many reasons that can cause anaemia. Keep reading to know all about anaemia.

What Is Neonatal Anaemia?

To help explain anaemia, let's begin with a little background on blood cells. Blood is made up of different kinds of cells, almost half of which are red blood cells. These cells contain a red-pigmented protein called haemoglobin. The job of haemoglobin is to carry oxygen to tissues in the body and carry away carbon dioxide, which is a waste material.

Neonatal anaemia occurs due to a lack of enough haemoglobin in the red blood cells or healthy red blood cells that transport oxygen throughout the baby’s body. This can cause problems with cell function and growth.

What Causes Anaemia in Newborns and Babies?

Some of the causes and risk factors of anaemia in newborns and babies include the following:

  • Not enough red blood cells are produced:

This is frequently due to an iron deficiency, which can occur when young babies start drinking cow's milk too early (cow's milk has very little iron and should not be introduced before the age of 1). In rare cases, another nutritional deficiency could be the issue, such as a lack of folic acid.

  • Too many red blood cells get destroyed:

This may happen when a child has a condition like haemolytic anaemia or sickle cell anaemia, which is most common in those of African heritage.

  • The red blood cells don’t contain enough haemoglobin:

Inherited blood disorders such as thalassemia, often seen in those of Asian, African, Middle Eastern, Greek, and Italian heritage, can lead to not enough haemoglobin or even a low number of red blood cells.

  • The body has lost blood:

This can result from an injury or from a condition such as haemophilia, in which the blood doesn't clot properly.

What Are the Symptoms of Anaemia in Babies?

Decreased levels of iron can affect your child's ability to function well. However, most signs don't show up until iron deficiency anaemia occurs. The following are some common signs and symptoms of anaemia in infants:

  • Pale skin:

The inside of lips, the lining of the eyelids, and nail beds start looking less pink than normal. This happens due to low levels of haemoglobin.

  • Fatigue:

You may feel very tired, weak, and sleepy more than usual. Due to lack of sufficient haemoglobin, less oxygen reaches your tissues and muscles, striping your energy.

  • Cold hands and feet:

Due to lack of oxygen supply to hands and legs, your hands and feet may feel the cold more easily.

  • Frequent infections:

Iron is essential for immunity. Due to iron deficiency, you are vulnerable to different infections.

  • Unusual cravings:

Strange cravings for non-nutritive foods or non-food items, called pica, occurs due to iron deficiency. Pica usually involves cravings to eat ice, chalk, paper, clay, or dirt.

Other symptoms may include:

  • Slowed growth and development

  • Abnormally rapid breathing

  • Behavioural problems

  • Yellow skin and/or eyes (jaundice)

  • Dark-coloured urine

  • Poor appetite.

Signs of severe anaemia can include:

  • Shortness of breath:

Haemoglobin helps carry oxygen throughout your body. Due to its low level, your body isn't able to transfer oxygen sufficiently to muscles and tissues. This leads to shortness of breath.

  • Heart palpitations:

Low levels of haemoglobin means the heart has to work extra hard to supply oxygen throughout the body. This can cause irregular or rapid heartbeats. In severe cases, it can also lead to a heart murmur, enlarged heart or heart failure.

  • Restless legs syndrome:

There is a strong urge to move the legs at rest, as it causes strange crawling or itchy sensations in your legs and feet. This symptom usually gets worse at night, making it difficult for you to sleep.

  • Headaches and dizziness:

As the supply of oxygen to the brain is less due to low haemoglobin, your blood vessels may swell, causing headaches.

Your baby’s anaemia may be due to an iron deficiency. This type of anaemia commonly affects babies between 9 and 24 months. The following are some of the iron deficiency symptoms in babies:

  • Decreased appetite

  • Irritability

  • Fussiness

  • Inattentiveness

If you notice any of the above signs and symptoms in your child, or if you think she’s not getting enough iron in her diet, consult her doctor.

How Is Anaemia Treated in Babies?

Because there are many different kinds of anaemia with different treatments, it’s best to follow your baby’s doctor’s advice on how to treat your baby's anaemia. Do not give your baby vitamins, supplements, or any other over-the-counter medication without first getting your doctor’s OK.

To treat your baby’s anaemia, the doctor may recommend medications, dietary restrictions, or supplements. If the anaemia is due to a lack of iron, the doctor may prescribe a medication for iron in liquid drop form.

The doctor may want to see your baby periodically to check her iron levels. It's important that she’s getting just the right amount of iron supplementation and not too much. Do not stop giving your baby the iron medicine unless your doctor has told you it’s no longer needed.

If it’s determined that your baby’s anaemia is due to a blood cell disorder like haemolytic anaemia, sickle cell anaemia, or thalassemia, your baby’s doctor may refer you to a haematologist, a doctor who specialises in blood conditions.

If your newborn was born prematurely or if your baby is very ill, in some cases, your little one’s doctor may recommend a blood transfusion to treat the anaemia.

When you contact the doctor or take your baby in for an examination, be sure to mention any signs and symptoms of anaemia you've observed and if there is a family history of anaemia or problems with bleeding.

How to Prevent Anaemia in Babies?

Not all types of anaemia can be prevented, especially those that are due to genetic conditions, such as sickle cell anaemia or thalassemia. However, anaemia due to an iron deficiency or another nutritional deficiency can be prevented by adhering to a well-balanced diet.

Here are some ways that you may be able to prevent nutritional anaemia in your baby:

  • Don’t give your baby cow’s milk until he is at least 12 months old.

  • If your baby is breastfed, your doctor may start your baby on an iron supplement at about 4 months old, in most cases continuing supplementation until complementary solids have been introduced (at about 6 months) that are high in iron, such as iron-fortified cereals and pureed meats.

  • If your baby is formula-fed, choose a baby formula that has added iron. Avoid low-iron formula.

  • After your baby has turned 12 months old, feel free to introduce cow’s milk but don’t offer more than 2 cups per day. Milk is low in iron, and anything more than that can cause your baby to feel full, and therefore less likely to eat iron-rich foods.

  • Once your baby is accustomed to eating solids, opt for a well-rounded diet for your baby, including iron-rich foods such as red meat, egg yolks, potatoes, tomatoes, beans, dried fruit, and dark, leafy greens.

  • Include foods rich in vitamin C, as this vitamin helps with iron absorption. Foods high in vitamin C include citrus fruits, orange juice, peppers, tomatoes, spinach, and broccoli.


Usually, anaemia can be treated almost with changes in your little one’s diet or medicine or supplements provided by her doctor. If the anaemia is a result of a genetic condition, your baby’s doctor can recommend a specialist for treatment options.

If you ever feel that your baby may have anaemia and you’ve noticed some signs and symptoms, like lethargy or pale skin, talk to your baby’s doctor. He can recommend a simple blood test to check your baby's haemoglobin levels.

After a successful diagnosis, your baby’s doctor can recommend the right course of action, and your baby will be back to the ideal health before you know it.

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