Anemia in Children: Recognizing the Symptoms and Causes

Anemia in children is a condition in which the body has a lower-than-normal number of red blood cells or hemoglobin levels. Hemoglobin is a protein in red blood cells that carries oxygen throughout the body. When the number of red blood cells or the hemoglobin level is insufficient, the supply of oxygen to body tissues may be affected.

Anemia is not always a disease in itself; it can also be a sign of an underlying health condition. In children, anemia may occur temporarily due to nutritional deficiencies or blood loss. However, it can also be associated with chronic diseases, genetic disorders, autoimmune conditions, and even cancer. The severity of anemia varies, ranging from mild cases that are easily treated to serious conditions requiring medical care.

According to the World Health Organization (WHO), approximately one-quarter of the world’s population experiences anemia, including nearly half of all preschool-aged children. Globally, iron-deficiency anemia is the most common type. Anemia in children may also be caused by hemoglobin disorders, infections, and other chronic diseases.

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Types of Anemia in Children

Anemia in children is classified into several types based on its cause and the mechanism involved. Some types result from nutritional deficiencies, such as iron deficiency, while others are associated with genetic disorders or problems with red blood cell production and destruction. The following are several types of anemia that can occur in children:

Iron-deficiency anemia. This condition occurs when a child’s body does not have enough iron. Iron is needed to produce hemoglobin, the protein in red blood cells responsible for carrying oxygen. Iron deficiency is the most common cause of anemia.
Megaloblastic anemia. This condition is characterized by red blood cells that are larger than normal due to a deficiency of folate or vitamin B12. One type is pernicious anemia, a condition in which the body has difficulty absorbing vitamin B12, which is needed to produce red blood cells.
Hemolytic anemia. This type of anemia occurs when red blood cells are destroyed faster than the body can replace them. Causes vary and may include severe infections or the use of certain medications.
Sickle cell anemia. This inherited type of anemia belongs to a group of conditions called hemoglobinopathies, which affect hemoglobin. It causes red blood cells to develop an abnormal, crescent or sickle shape.
Cooley’s anemia (thalassemia). Thalassemia is an inherited form of anemia that interferes with hemoglobin production, causing red blood cells to function abnormally.
Aplastic anemia. This condition occurs when the bone marrow fails to produce enough blood cells, including red blood cells. As a result, children may develop anemia and abnormalities involving other types of blood cells.

What Are the Symptoms of Anemia in Children?

Symptoms of anemia can vary from child to child, depending on the type and underlying cause. Some symptoms are characteristic of certain types of anemia, but many are nonspecific and may resemble those of other illnesses. Anemia may also indicate an underlying medical condition. Common symptoms of anemia in children include:

Pale skin, lips, palms, or the inside of the eyelids.
An increased or faster-than-normal heart rate (tachycardia).
Shortness of breath or difficulty breathing.
Low energy, fatigue, or weakness.
Dizziness or a spinning sensation, particularly when standing up.
Headaches.
Irritability or increased fussiness.
Irregular menstrual cycles.
Absence of menstruation or delayed menstruation (amenorrhea).
A painful or swollen tongue (glossitis).
Yellowing of the skin, eyes, and inside of the mouth (jaundice).
An enlarged spleen or liver.
Slow growth or developmental delays.
Impaired wound healing and tissue repair.

Some symptoms of anemia may resemble those of other health conditions, including blood disorders. Therefore, if a child shows symptoms that may indicate anemia, a medical examination is necessary to confirm the diagnosis and determine the appropriate treatment.

Recognizing the Causes of Anemia in Children

The causes of anemia in children depend on the type of anemia they have. Common causes include:

Nutritional deficiencies, such as a lack of iron, folate, or vitamin B12.
Inherited diseases, such as Fanconi anemia, thalassemia, and sickle cell anemia.
Autoimmune diseases, in which the immune system attacks the body’s own cells or tissues.
Bleeding, which can cause the body to lose red blood cells.
Certain cancers that may affect blood cell production or function.
Certain medications that may affect red blood cells or their production.
Infections that can interfere with red blood cell production or increase their destruction.

How Do Doctors Diagnose Anemia in Children?

Diagnosing anemia in children begins with a medical evaluation to confirm the condition and identify its underlying cause. Anemia is generally detected through a simple blood test that measures hemoglobin levels and red blood cell counts. To investigate the underlying cause, doctors may perform the following examinations:

Medical history and physical examination: The doctor asks about the child’s medical history and examines their physical condition.
Hematocrit test: Measures the percentage of red blood cells in a given volume of blood.
Hemoglobin electrophoresis: Examines the amount and types of hemoglobin in the blood to help identify hemoglobin disorders.
Additional blood tests: Performed as needed to investigate the cause of anemia.
Bone marrow aspiration and biopsy: Performed when necessary to evaluate blood cell production.

Doctors may recommend additional tests based on each child’s condition. Once the necessary examinations have been completed, the results are evaluated to establish a diagnosis and determine the appropriate treatment.

Treatment for Anemia in Children Depends on the Underlying Cause

Treatment for anemia in children depends on the type of anemia, its cause, and the child’s overall health. Doctors may recommend several treatment options, including:

Vitamin and mineral supplements, such as iron, folate, or vitamin B12, if the child has a deficiency.
Dietary changes to help meet the child’s nutritional needs.
Starting or discontinuing certain medications, depending on the cause of anemia and the doctor’s evaluation.
Treatment of the underlying condition, particularly when anemia is associated with chronic disease or another medical condition.
Surgical removal of the spleen, in certain cases of hemolytic anemia when indicated.
Blood transfusions, if the child has experienced significant blood loss or has another medical indication.
Antibiotics, if the anemia is associated with a bacterial infection that requires this treatment.
Stem cell transplantation, for certain conditions that cause bone marrow failure, such as aplastic anemia, Fanconi anemia, or Diamond-Blackfan anemia.

The doctor will determine the most appropriate treatment approach by considering the child’s age, overall health, severity of anemia, and response and tolerance to the medications or therapies provided.

Pediatric Hematology-Oncology Consultants at Mandaya Royal Puri Hospital

Anemia in children can be associated with various conditions, ranging from iron deficiency to blood disorders and diseases that affect red blood cell production. Identifying the cause may require evaluation and treatment by a pediatric hematology-oncology consultant. At Mandaya Royal Puri Hospital, specialists are available to manage various blood disorders and childhood cancers, including anemia, thalassemia, leukemia, and solid tumors.

1. dr. Ludi Dhyani Rahmartani, Sp.A, Subsp. H.Onk (K)

dr. Ludi Dhyani Rahmartani, Sp.A, Subsp. H.Onk (K), is a pediatric hematology-oncology consultant at Mandaya Royal Puri Hospital who treats various blood disorders and cancers in children. Her expertise includes leukemia, thalassemia, brain tumors, and other types of childhood cancer. Her care covers the diagnostic process, treatment planning, and monitoring the child’s condition throughout treatment.

dr. Ludi earned her medical degree from the University of Indonesia in 2002. She subsequently completed her pediatric specialist training at the same university in 2015 before pursuing subspecialty training in pediatric hematology-oncology, which she completed in 2021.

Some of the conditions and medical procedures within dr. Ludi’s area of expertise include:

Treating childhood leukemia, including chemotherapy and treatments tailored to the type of leukemia.
Managing thalassemia and various blood disorders in children.
Treating brain tumors and other types of childhood cancer.
Providing chemotherapy, targeted therapy, and immunotherapy for childhood cancer.
Bone marrow transplantation.

dr. Ludi Dhyani Rahmartani, Sp.A, Subsp. H.Onk (K), is available at Mandaya Royal Puri Hospital on the following schedule:

Thursday: 5:30–7:30 PM WIB.

2. dr. Fatimah Saidah, Sp.A, Subsp. H.Onk. (K)

dr. Fatimah Saidah, Sp.A, Subsp. H.Onk. (K), is a pediatric hematology-oncology consultant at Mandaya Royal Puri Hospital with expertise in treating blood disorders and cancer in children. Her scope of care includes various conditions, ranging from anemia and thalassemia to blood cancers and solid tumors, including brain tumors.

In treating childhood cancer, dr. Fatimah has expertise in systemic therapies, such as chemotherapy, as well as bone marrow transplantation when medically indicated. Treatment is tailored to the type of disease and each patient’s individual condition.

Some of dr. Fatimah’s areas of expertise include:

Treating blood disorders in children, such as anemia, thalassemia, and blood cancers.
Treating blood cancers with chemotherapy and bone marrow transplantation when medically indicated.
Managing childhood cancers and solid tumors, including brain tumors.

dr. Fatimah Saidah, Sp.A, Subsp. H.Onk. (K), is available at Mandaya Royal Puri Hospital on the following schedule:

Monday: 5:00–7:00 PM WIB.
Wednesday: 5:00–7:00 PM WIB.
Friday: 5:00–7:00 PM WIB.

Facilities for Patients Traveling from Other Cities and International Patients at Mandaya Royal Puri Hospital

Mandaya Royal Hospital Puri provides a range of supporting facilities to offer additional comfort for patients traveling from other cities or abroad.

VIP Transport: Pick-up services from Soekarno-Hatta International Airport, train stations, or seaports to the hospital in comfortable vehicles, accompanied by a Patient Experience Officer (PEO).
Medical Ambulance Pick-Up: Dedicated pick-up services for patients with specific medical needs from arrival points, including airports, train stations, and seaports. These services are equipped with medical equipment and supported by professional healthcare personnel.
Accommodation (Sleep Hub and Apartments): Comfortable accommodation for family members accompanying patients. The Sleep Hub is located on the 8th floor of the Mandaya Royal Puri building, with nearby apartments also available.
International Patient Relation: Dedicated assistance for international patients, including medical coordination, interpretation, and administrative support. For information and assistance, contact International Patient Relation at 021 5092 8888 or email [email protected].

To make your visit to Mandaya Royal Hospital Puri easier, use the WhatsApp chat feature, Book Appointment service, or the Care Dokter application, available for download on Google Play and the App Store. These options can help you manage appointments, check queue numbers, and access other relevant information.

The information on this page is provided for educational purposes and as a general overview. It does not cover every type of medical service that each doctor may perform. To determine the most appropriate treatment for your health condition, you are advised to consult the relevant doctor directly.

If you have any questions, suggestions, or need further information, please contact our call center at 0811-1900-2000.