Newborn Anemia

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KEY POINTS

• Newborn anemia is when a baby has fewer healthy red blood cells than normal.
• Newborn anemia does not need to be treated unless it causes a problem for the baby or the blood count drops too low.
• Premature babies may need a blood transfusion, which means the baby may be given red blood cells from someone else.

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What is newborn anemia?

A baby who has anemia has fewer healthy red blood cells than normal. The red blood cells carry oxygen in the blood and deliver it to the rest of the body.

What is the cause?

Throughout our lives red blood cells get old and break down and our bodies make new red blood cells to replace them. Newborn babies don't start to make new red blood cells until they are about 1 month old. As some of the older red blood cells start to break down, your baby may not have enough new red cells to replace them for the first 2 or 3 months of life. For every newborn baby, this causes a mild type of anemia called physiologic or normal anemia. Once a baby starts making new red blood cells, the red blood cell count gradually goes back to normal.

Some newborns may become more anemic than normal because of:

• Blood loss. Sometimes a baby loses blood during birth.
• Rapid breakdown of red blood cells. Red blood cells may break down faster than normal. This can happen, for example, if the mother and baby do not have the same blood type.
• Slow red blood cell production. Some babies may take longer to start making red blood cells. This can be caused by a lack of iron or other nutrients in the baby’s blood, an infection, or a problem with the blood-forming cells.
• Premature birth. Premature babies have fewer red blood cells at birth and their red blood cells break down faster. They may also lose blood from frequent blood tests.

What are the symptoms?

Most babies don’t have any symptoms from normal newborn anemia. When a baby does have symptoms of anemia, they happen because the cells in the body are not getting enough oxygen from the blood. Symptoms may include:

• Being sleepier or more tired than normal
• Pale or yellowish skin
• Fast heartbeat
• Fast breathing rate

How is it diagnosed?

A baby’s red blood cells can be counted with a simple blood test.

How is it treated?

Anemia is normal for newborns and does not need to be treated unless it causes a problem for the baby or the blood count drops too low.

Iron is needed to make red blood cells. Your healthcare provider may recommend that you give your baby iron drops or iron-fortified formula.

Babies with symptoms and premature babies may need a transfusion of blood, which means the baby may be given red blood cells from someone else. The smaller a premature baby is, the more likely it is that the baby will need 1 or more transfusions in the first 2 months of life. Usually the blood is from volunteers who donate to a blood bank. It may also be possible for family members to donate blood for the baby.

How can I take care of my child?

Don’t give your baby iron unless it’s prescribed by your provider and don’t give more than prescribed. Ask your provider how long your baby may need an iron supplement.

Follow your child’s healthcare provider's instructions. Ask your provider:

• How and when you will get your child’s test results
• How long it will take for your child to recover
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.