children s health issues
Anemia in the Newborn
Introduction
Anemia is a disorder in which there are too few red blood cells in the blood. Anemia can occur when red blood cells are broken down too rapidly, too much blood is lost, or the bone marrow does not produce enough red blood cells. If red blood cells are broken down too rapidly, anemia may develop and levels of bilirubin (a yellow pigment produced during the normal breakdown of red blood cells) increase, and the newborn’s skin and the whites of the eyes can appear yellow (a condition called jaundice). If a large amount of blood is lost very rapidly, the newborn may become seriously ill and develop shock, appear pale, have a rapid heart rate, and have low blood pressure along with rapid, shallow breathing. If there is less severe blood loss, or the blood is lost gradually, the newborn may appear normal but pale. Treatment may involve fluids given by vein (intravenously) followed by a blood transfusion or an exchange transfusion. Red blood cells contain hemoglobin, a protein that gives blood its red color and enables it to carry oxygen from the lungs and deliver it to all body tissues. Oxygen is used by cells to help produce from food the energy that the body needs, leaving carbon dioxide as a waste product. Red blood cells carry carbon dioxide away from the tissues and back to the lungs. When the number of red blood cells is too low, blood carries less oxygen, and fatigue and weakness develop (see also Overview of Anemia in adults.) Bone marrow contains specialized cells that produce blood cells. Normally, the bone marrow produces very few new red blood cells between birth and 3 or 4 weeks of age, causing a slow drop in the red blood cell count (called physiologic anemia) over the first 2 to 3 months of life. Very Preterm (Premature) Newborns have a greater drop in red blood cell count. This condition is called anemia of prematurity. Anemia of prematurity most commonly affects infants whose More severe anemia can occur when Red blood cells are broken down too rapidly (a process called hemolysis). A lot of blood is taken from premature newborns for blood tests. Too much blood is lost during labor or delivery. The bone marrow does not produce enough new red blood cells. More than one of these processes can occur at the same time. 