Anemia can be defined as a hemoglobin concentration below the normal range for a population of age and sex-matched individuals. Regardless of gestational age, any neonate of hemoglobin < 14 g/dL at birth in a properly taken blood sample should be considered anemic.

Anemia occurs when red blood cells are broken down too quickly, a large amount of blood is lost, or the bone marrow does not create enough red blood cells. In general, central venous hemoglobin < 13 g/dL or capillary hemoglobin < 14.5 g/dL in infants> 34 weeks of gestational age, aged 0-28 days is considered anemic.

In healthy term infants, hemoglobin levels begin to decline around the week of life known as physiologic anemia i.e. between 4th to 12th week due to increased saturation of oxygen in the blood.

Common causes of neonatal anemia

Anemia is the most common hematologic abnormality in newborns. They are;

Due to loss of blood/ Hemorrhagic anemia

Placental abnormality
Umbilical anomaly
Presence of knots or hematoma
Twin to twin transfusion
Umbilical traumatic rupture
Feto-maternal bleeding
Birth trauma
Congenital deficiency of coagulation factors
Thrombocytopenia
Deficiency of vitamin K dependant factors

Increased destruction of Red blood cells/ Hemolytic anemia
ABO-Rh incompatibility
Autoimmune
sepsis/ infection
TORCH Infection
Congenital erythrocyte disorders
Nutritional deficiency

Insufficient production of RBCs/ Hypoplastic anemia

Congenital leukemia
Rubella
Syphilis
Diamond Blackfan syndrome

Signs & symptoms

The majority of newborns with mild or severe anemia exhibit no symptoms. The development of symptoms depends on the progression speed of anemia and the cause.

Pallor with /without cyanosis or jaundice
Poor weight gain
Lethargy
Decreased activity
Increased heart rate
Difficulty with oral feeding
Apnea
Metabolic acidemia
Hepatomegaly or enlargement of liver

Complications

Newborns who have lost a substantial amount of blood during labour or delivery may be in shock, seem pale, have a high heart rate and low blood pressure, and breathe quickly and shallowly.

When anemia is caused by a rapid breakdown of red blood cells, there is a rise in bilirubin production, and the newborn's skin and whites of the eyes may appear yellow (jaundice).

When to see a doctor

The age along with associated symptoms and the overall delivery status of the infant is crucial to determine the severity. Connect with a Pediatric expert as soon as you notice any of the above-mentioned signs.

The doctor will assess the newborn vitals and will order the required diagnostic blood test to rule out the causes by following diagnostic tests;

Prenatal ultrasounds if anemia diagnosed before birth.
Assessment of symptoms and blood tests are done, if anemia diagnosed after delivery

Treatment

The majority of healthy premature babies have mild anemia and don't need any therapy for it. While for the rest;

Fluids through the vein and a blood transfusion are used to treat anemia brought on by fast blood loss.
Treatment options vary for hemolytic disease-induced anemia.
Occasionally, iron supplements are given.
Jaundice in newborns may be treated with phototherapy, which lower the bilirubin level.

Anemia in newborns is a condition in which the baby's body has a lower than normal red blood cell count. This can happen for numerous reasons, including if the infant is early, the red blood cells break down too quickly, the body doesn't make enough red blood cells or the newborn loses too much blood.

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1. Is infant anemia common?

Due to their rapid growth, newborns are more likely to acquire iron deficiency anemia than adults.

2. What is the normal value for a baby's hemoglobin?

Mean 16.5 g/dL (-2SD: 13.5 g/dL) at birth Mean 18.5 g/dL (-2SD: 14.5 g/dL) for the past three days Mean 17.5 g/dL for one week (-2SD: 13.5 g/dL) Mean 16.5 g/dL over two weeks (-2SD: 12.5 g/dL) Mean 14.0 g/dL over a month (-2SD: 10.0 g/dL) Mean 11.5 g/dL over 2 months (-2SD: 9.0 g/dL)

3. What happens if a baby is anemic?

Anemia prevents a newborn's body from receiving enough oxygen. The baby experiences fatigue and loses energy as a result. Mild anemia affects a lot of newborns within a few months of birth. These situations don't need to be treated.

4. What does a baby with anemia look like?

Anemia can develop if red blood cells are broken down too quickly, and levels of bilirubin (a yellow pigment created during the normal breakdown of red blood cells) rise, making the newborn's skin and eye whites seem yellow.

5. What type of infant is most vulnerable to anemia?

Iron-deficiency anemia is more common in premature and low-birth-weight babies. These babies' bodies do not contain as much iron as larger, full-term neonates.