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There are many causes of anemia in kids, but the one thing they all have in common is keeping children and teens from fully enjoying an active childhood. The hematology and oncology team at Cook Children's is here to help young people with anemia get back to what they do best—be kids.

Red blood cells provide oxygen to the tissues in the body. When the body doesn't have enough healthy red blood cells, it results in anemia. There are many reasons why the body doesn't produce enough red blood cells, which also means there are many different types of anemia. Our job is to determine the best plan of care for your child. To do this, we have to determine the cause of your child's symptoms, the type of anemia he or she has and to identify any additional effects the anemia may be having on your child's overall health.

What is anemia?

The body makes blood cells in the bone marrow including red blood cells. Healthy red blood cells last approximately 90 to 120 days. When they are no longer needed, they are cleansed from the body. Once they have been removed, the kidneys signal the bone marrow to make more red blood cells. Red blood cells contain hemoglobin. Hemoglobin gives the cells their red color. More importantly, it contains the protein that carries oxygen to the body's tissues and brain. People with anemia don't have enough hemoglobin.

For the body to make red blood cells, it needs vitamins, minerals and nutrients, especially iron, vitamin B12 and folic acid. Poor diet, celiac disease, blood loss from heavy menstrual periods or bleeding ulcers are a few of the reasons the body may not have enough of these nutrients.

Other possible causes of anemia may include:

Bone marrow is a thick, spongy kind of jelly inside your bones. Bone marrow makes all kinds of blood cells: red blood cells that carry oxygen, white blood cells that fight infections, and platelets that help blood clot.


Children with a mild form of anemia may not have any symptoms. Early symptoms of anemia may first appear as the following:

  • Your child my seem irritable or grumpy
  • Children often feel weak or are more tired than usual, normal activities may wear them out more easily
  • Headaches

As the anemia progresses you may notice some of these symptoms:

  • Your child may get light-headed or dizzy when they stand up
  • Skin may become pale or ashen
  • Shortness of breath
  • The whites of the eyes may become yellow (hemolytic anemia)
  • Skin may become yellow and urine dark (hemolytic anemia)

These are the most common symptoms. Other symptoms may be present depending on the type of anemia your child has. Based on these symptoms or others that your doctor may be concerned about, your child will be scheduled for specific tests to help determine the cause of and type of anemia your child has and how to treat it.

Testing and diagnosis

The types of testing your child has will be determined by his or her symptoms and any current illnesses, conditions or medical treatments which may be causing or contributing to the anemia. The following tests are the most common and may reveal additional symptoms:

  • A complete medical history of your child and family
  • A physical examination which may reveal a heart murmur, low blood pressure, pale skin and/or a rapid heart rate
  • Blood tests to check levels of iron, vitamin B12, folic acid, other vitamins and minerals, red blood count, hemoglobin level, and reticulocyte count
  • There may be other tests depending on your child's symptoms and sometimes on the findings of these tests as well

Once all the test results are in, your hematology and oncology specialist will determine the cause of your child's anemia and create a plan of care and treatment to meet your child's needs.


Your child's treatment plan will be directed at the cause of the anemia. Depending of the cause, treatment may include:

  • Blood transfusions
  • Medication to suppress the immune system, such as corticosteroids
  • Erythropoietin (a medication designed to help your bone marrow make more blood cells)
  • Supplements like iron, vitamin B12, folic acid or other vitamins and minerals your child may need

Your child may also need other types of treatment which your specialist will include the plan of care.

We are here to help.

If your child has been diagnosed, you probably have lots of questions. We can help. If you would like to schedule an appointment, refer a patient or speak to our staff, please call our offices at 682-885-4007.