Neonatal anaemia is the condition of a decreased red blood cell count in newborns. Red blood cells contain haemoglobin, the protein that gives blood its red colour. Haemoglobin also helps carry oxygen to the lungs and delivers oxygen to the rest of the body as well. Having adequate oxygen throughout the body is necessary for energy.
When there is a decrease in red blood cells, there is less oxygen in the blood, and as a result, infants may experience fatigue, poor feeding habits, pale skin, a rapid heart rate, and rapid breathing. Bone marrow in the body contains special cells that produce red blood cells. Normally from birth to 3 to 4 weeks of age, there is a drop in red blood cells because the bone marrow produces fewer red blood cells at this stage.
A sudden drop in red blood cells may also cause yellowing of the skin and whites of the eyes. This is a condition called jaundice and may need to be treated in addition to the anaemia. It is important to be aware of these conditions that more commonly affect infants in the first few months of life and follow up with your infant’s health care professional and report any concerns or changes that you may notice.
There may be several different reasons why an infant develops anaemia. Your healthcare provider will try to find out the cause of the anaemia and then recommend treatment options.
In some cases of neonatal anaemia, there is no treatment recommended other than closely monitoring for worsening symptoms.
When the cause of anaemia is physiologic anaemia, the baby’s body is growing so fast that the red blood cell production can hardly catch up. To treat this, your healthcare provider will likely recommend close monitoring for worsening symptoms.
If the cause of anaemia is the body breaking down red blood cells too rapidly, a process known as haemolysis, there may be noticeable yellowing of the newborn’s skin and whites of eyes. This condition, known as jaundice, is the buildup of bilirubin in the blood and is treated with phototherapy or “bili lights” if it does not clear on its own.
If the cause of anaemia is from blood loss during labour and delivery or from frequent blood draws, IV fluids, and a blood transfusion may be necessary.
In the case of the infant having a haemolytic disease, an exchange transfusion may be the best treatment option. An exchange transfusion is when a small amount of the infant’s blood is gradually removed and replaced with equal volumes of fresh donor blood. This can help lower the bilirubin levels and increase the red blood cells.
Another treatment option that your healthcare provider may recommend for anaemia is a liquid iron supplement. This treatment can help increase the red blood cells faster. As with all treatment options, it is important to seek the advice of a trusted healthcare professional and report any questions or concerns you may have.
There are several reasons why an infant may develop anaemia. Some conditions of anaemia are mild enough that no treatment is required. However, the following are causes and risk factors of neonatal anaemia that will likely require treatment.
This is more common for infants in neonatal intensive care, where frequent blood draws are necessary for testing. Internal bleeding can also cause blood loss. A traumatic delivery where more blood loss than usual occurs can also cause anaemia.
Premature infants do not have as much iron produced and stored as a full-term baby.
This can result from iron deficiency or from bone marrow not producing red blood cells due to an infection or a genetic condition.
This occurs when the infant’s red blood cells do not live as long as normal due to various underlying causes.
Once treated, neonatal anaemia does not usually cause any long-term complications. While mild anaemia is not uncommon in many infants and may not even require any treatment, it is important to monitor for worsening symptoms, especially in premature infants.
Routine follow-up appointments and discussing any health concerns with your infant’s healthcare provider are important and can help ensure the well-being of your infant.