Definition

Anemia is a low level of healthy red blood cells (RBC). RBCs carry oxygen from the lungs to the rest of the body. Iron is needed to build healthy RBCs. Lower RBC counts mean the body is not getting enough oxygen.

Causes

Factors that play a role include:

• Iron that is poorly absorbed in the digestive tract—may occur due to intestinal diseases or surgery
• Chronic bleeding , such as heavy menstrual bleeding or bleeding in the gastrointestinal (GI) tract
• Not enough iron in the diet—common cause in infants, children, and pregnant women

Risk Factors

These factors may increase your chance of developing this condition:

• Rapid growth cycles—may occur with infancy or adolescence
• Heavy menstrual bleeding or chronic blood loss from the GI tract
• Pregnancy
• Diets that contain insufficient iron—rare in the United States
• Breastfed infants who have not started on solid food after 6 months of age
• Babies who are given cow’s milk prior to age 12 months
• Alcoholism

Symptoms

Most people with mild anemia have no symptoms. In those that have them, anemia may cause:

• Fatigue
• Pale skin
• Fingernail changes
• Weakness
• Headache
• Decreased work capacity
• Heart palpitations
• Infection
• Craving to eat things that are not food (called a pica), such as ice or clay
• Hair loss
• Shortness of breath during or after physical activity

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests may include:

• Serum iron
• Transferrin iron binding capacity
• Serum ferritin level
• Microscope examination of a blood smear
• Fecal occult blood test —to look for hidden blood in the stool

Treatment

Treatments may include:

Prevention

To help reduce your chance of having anemia:

• Eat a diet rich in iron, such as oysters, meat, poultry, or fish
• Avoid foods that interfere with iron absorption, such as black tea

Ask your doctor if your infant is getting enough iron. General guidelines include:

• Starting at 4 months, breastfed infants need an iron supplement until they get enough iron from other sources, like infant cereal or iron-fortified formula.
• Bottle-fed infants should get a formula that is fortified with iron.
• Many premature infants need extra iron starting at 1 month of age.

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