Symptoms of Anemia

Anemia causes a mild paleness of the skin, usually most apparent as a decreased pinkness of the lips, the lining of the eyelids (conjunctiva) and the nail beds (pink part of the nails). Anemic children may be irritable, mildly weak or tire easily. Those with severe anemia may have shortness of breath, rapid heart rate, and swelling of the hands and feet. If the anemia continues, it may interfere with normal growth. A newborn with hemolytic anemia may become jaundiced (turn yellow), although many newborns are mildly jaundiced and don't become anemic. If your child shows any of these symptoms, or if you suspect he is not getting enough iron in his diet, consult your pediatrician. A simple blood count can diagnose anemia in most cases.

Some children are not anemic but still are deficient in iron. These youngsters may have decreased appetite, be irritable, fussy and inattentive, which may result in delays in their development or poor school performance. These problems will reverse when the children are given iron. Other signs of iron deficiency that may be unrelated to anemia include a tendency to eat weird things, such as ice, dirt, clay and cornstarch. This behavior is called pica. It is not harmful unless the material eaten is toxic (such as lead). Usually the behavior improves after the anemia is treated and as the child becomes older, although it may persist longer in children who are developmentally delayed.

Because there are so many different types of anemia, it is very important to identify the cause before any treatment is begun. Do not attempt to treat your child with vitamins, iron, or other nutrients or over-the-counter medications unless it is at your physician's direction. This is important because such treatment may mask the real reason for the problem and thus delay the diagnosis.

If the anemia is due to lack of iron, your child will be given an iron-containing medication. This comes in a drop form for infants, and liquid or tablet forms for older children. Your pediatrician will determine how long your child should take the iron by checking his blood at regular intervals. Do not stop giving the medication until the physician tells you it is no longer needed.

Following are a few tips concerning iron medication:

It is best not to give iron with milk because milk blocks the absorption.
Vitamin C increases iron absorption, so you might want to follow the dose of iron with a glass of orange juice.
Since liquid iron tends to turn the teeth a grayish-black color, have your child swallow it rapidly and then rinse his mouth with water. You may want to brush your child's teeth after every dose of iron. Although tooth-staining by iron is unattractive, it is not permanent.
Iron medications cause the stools to become a dark black color. Don't be worried by this change.
Safety precautions: Iron medications are extremely poisonous if taken in excessive amounts. (Iron is one of the most common causes of poisoning in children under age 5.) Keep this and all medication out of reach of small children.

Iron-deficiency anemia and other nutritional anemias can be prevented easily by making sure your child is eating a well-balanced diet and by following these precautions:

Do not give your infant cow's milk until he is older than 1 year old.
If your child is breastfed, give him iron-fortified foods such as cereal when solid foods are introduced. Before then, he will absorb enough iron from breast milk. If you choose to solely breastfeed beyond four months, an iron supplement is recommended. However, the introduction of iron-poor solid foods will decrease the amount of iron your baby absorbs from the milk.
If your baby is formula-fed, give him formula with added iron.
Make sure your older child has a well-balanced diet and eats foods that contain iron. Many grains and cereals are iron-fortified (check labels to be sure). Other good sources of iron include egg yolks, green and yellow vegetables, yellow fruits, red meat, potatoes, tomatoes, molasses and raisins. Also, to increase the iron content of your entire family's diet, use the fruit pulp in juices and cook potatoes with the skins on.