Anaemia in Babies

Anaemia occurs due to the shortage of red blood cells in the body. These cells carry oxygen from the lungs to the tissues in the body, so their shortage can lead to a range of symptoms such as weakness, pale skin, rapid heartbeat etc. Anaemia can be prevented with proper supplementation of iron in the food.

What is Anaemia in Infants?

The signs of anaemia in babies are tiredness, pale skin, loss of appetite, irritability, brittle nails, sore or swollen tongue, and rapid heartbeat. It is due to the lack of red blood cells that oxygen is not transported to all the tissues in the body. The most common cause of anaemia in babies is the deficiency of iron which is vital for making red blood cells that carry oxygen. Long-term effects of anaemia in infants include a delay in reaching developmental milestones.

Possible Causes of Anaemia in Babies

Some causes of anaemia in infants include:

1. A genetic disorder: The sickle cell disease is a genetic disorder that destructs red blood cells (RBCs) in the bloodstream. RBCs transport oxygen to all the tissues in the body and the disorder makes the body’s immune system attack the healthy RBC. Called hemolytic anaemia, the excessive loss of RBCs is higher than the replenished cells which lead to anaemia.

2. Loss of blood: Blood loss resulting from an internal bleeding or a wound due to an injury leads to the loss of RBCs. Other factors that contribute to it include frequent nose bleeding, bloody diarrhoea and inflammatory bowel disease.

3. Low production of RBCs: When RBCs are not being produced enough by the bone marrow, it is called aplastic anaemia. This can be due to bacterial or viral infections, side effects of medications, or certain forms of cancers involving the blood or the bone. However, iron deficiency anaemia is the most common cause of aplastic anaemia in infants.

What is Iron Deficiency Anaemia in Babies?

Anaemia can be classified as a deficiency disorder when it is caused by the deficiency of Iron as a dietary nutrient. The red blood cells contain haemoglobin, an iron-containing protein, that carries oxygen to the different parts of the body. If your baby doesn’t get enough iron in food, they’ll have less red blood cells, leading to an iron deficiency anaemia. Babies are especially susceptible to anaemia during their growth spurts. However, it should be noted that iron-deficiency anaemia doesn’t occur overnight. It is caused by a prolonged deficiency of iron. Also, deficiencies can occur due to reasons such as lesser amounts of iron in the food or blood loss in the intestinal tract.

What Causes Low Iron in Infants?

Deficiency of iron in infants is caused by many reasons such as:

1. Insufficient dietary intake of iron: Babies have enough reserves of iron in their bodies, and they get plenty of it from breast milk to last until 6 months. Beyond that, they should be given plenty of iron-rich foods to meet their growing needs. All babies between the ages of 9 and 24 months are at the risk of anaemia and hence those who are fussy eaters and don’t eat enough iron-rich foods might develop anaemia.

2. Premature birth: Full-term babies are born with iron reserves in their bodies which can last them from 4 to 6 months, on the other hand, premature babies may have reserves that could last only for about two months or so; hence they are at a higher risk of developing anaemia. It is seen that about 85% of premature babies below a weight of 1.5kg can develop anaemia.

3. Diabetic Mothers: Babies who are born to diabetic mothers who did not take care of it properly are at a greater risk of developing anaemia.

4. Low birth weight: Haemoglobin levels of a mother are responsible for low birth weight and anaemia in babies; especially if the mother had been anaemic during the third trimester.

5. Introducing cow’s milk before 1 year:  Babies who are introduced to cow’s milk before they are 12- months-old are at the risk of developing anaemia. Cow milk has low iron-content, and it also interferes with the body’s absorption of iron. Cow’s milk can also irritate the intestine’s lining and cause bleeding.

What are the Symptoms of Iron Deficiency in Young Child?

Here are some of the signs of anaemia in babies:

1. Pale skin: When a baby is anaemic, his skin loses its colour and texture and appears pale and dull. It is predominantly noticeable around the eyelids and hands.

2. Lethargy: Anaemic babies also may have low energy and show acute drowsiness most of the times.

3. Weakness: A baby with anaemia is tired all the time and shows lack of interest in activities.

4. Low appetite and no interest in eating food: If your baby has anaemia, he will eat very less or not eat at all.

5. Irritability: Babies maybe constantly irritated for unknown reasons and the older ones may also show tantrums.

6. Difficulty in breathing: Anaemic babies may have trouble breathing as they tire themselves out trying to get as much oxygen as possible. They also suffer from shortness of breath frequently.

7. Faster heart rate: In anaemic babies, the heart tries to pump more blood and hence beats faster with irregular beating pattern.

8. Swelling in limbs: Some babies might have swelling in limbs, hands, and feet.

9. Pica: Pica is a condition characterized by infants craving for non-food items such as mud, chalk, metal etc. This is an important indicator of a nutrient deficiency of some sort.

10. Lowered growth rate: Since the body doesn’t get sufficient oxygen for its metabolic processes, babies show poor growth in terms of head circumference, height, and weight for their age.

How to Diagnose Iron Deficiency Anaemia in Infants?

There are certain tests that can be done to diagnose anaemia in babies:

1. RBC Test: A drop of your baby’s blood is observed under a microscope to look for the low count or the small size of the RBCs. Counting is also done to estimate the number of new and old RBCs to determine if their production is normal. The percentage of blood plasma is also determined by a hematocrit test. A small stool sample may also be tested to look for loss of RBC through internal bleeding.

2. Iron Test: A baby’s blood sample is tested for haemoglobin and iron levels. Ferritin, a protein that stores iron will also be tested. Screening for a genetic disease such as sickle cell may also be done.

How Can Iron Deficiency Anaemia Be Treated?

The treatment for anaemia in babies involves replenishing the lost iron in the baby’s body. It is done in the following ways:

1. Iron supplements: Iron supplements in the form of powder or syrups are given to boost iron intake. The supplements also contain vitamin C as it aids in the absorption of iron.

2. Iron-rich food supplements: The baby’s paediatric dietician would recommend a diet plan that is rich in iron to replenish the baby’s low iron reserves.

Does Iron Deficiency Anaemia Have Long-Term Effect On Your Anaemic Baby?

Anaemia in babies results in a delay in meeting the developmental milestones, as their growth rate is slower. Anaemia also compromises the baby’s immunity and makes it prone to infections. In severe cases of anaemia, it can lead to physical and mental retardation. Deficiency of iron leads to regressions in the skeletal muscles and functions of the brain which results in lower IQ. Babies may also have behavioural issues and problem in socializing.

Are There Any Preventive Measures?
There are certain measures that you can try to prevent anaemia in babies, they are as follows:

• If the baby is born preterm or has a low birth weight, discuss with your doctor about iron supplements and come up with a long-term treatment course.

• Do not feed cow’s milk to your baby until he is about a year old. Breast milk and iron-fortified formula milk should suffice.

• If the baby is 4-months-old and is breastfeeding, without having been introduced to solid foods, the AAP recommendation is 11mg of iron per day until they start eating iron-rich foods. This is a good way to avoid anaemia in breastfed babies.

• Once the baby starts on solid foods, they should be given iron-fortified cereal and eventually iron-rich foods. Poultry, lean meats, fish, green leafy vegetables, egg yolks, legumes and iron-fortified rice, and bread are ideal foods to start with.

• Vitamin C rich foods such as citrus fruits, avocados, kiwi, and cantaloupe should also be added to the diet.

With adequate supplementation of iron in food, anaemia can be avoided in babies.