Issues, causes and solutions for anemia in infants

What is anemia?

Anemia is a medical condition characterized by an insufficient number of red blood cells, or a hemoglobin level below normal. In anemia, the blood’s ability to carry oxygen to organs and tissues is reduced.

This is a global public health problem. Today, anemia affects 2 billion people worldwide, mainly women and children. In fact, 40% of children aged between 6 and 59 months suffer from anemia. South-East Asia and Africa are the regions most affected, with 83 and 103 million children respectively.

The different types of anemia

There are two types of anemia: one due to a defect in red blood cell production, the other due to an abnormal loss of red blood cells.

Anemia due to a defect in red blood cell production

When it comes to a defect in red blood cell production, deficiencies in iron, vitamin B12 and vitamin B9 are most often to blame. Iron is an essential component of hemoglobin, itself contained in red blood cells. So, in the absence of iron, the body cannot produce red blood cells. This very common deficiency affects 1.5 billion people worldwide, and is responsible for the majority of anemias.

However, there are other causes, such as inflammatory diseases, a deficiency in erythropoietin – a hormone that stimulates the bone marrow, where red blood cells are produced – or, more generally, a bone marrow dysfunction.

Anemia due to abnormal loss of red blood cells

Anemia due to abnormal loss of red blood cells can be caused by severe bleeding (e.g. gynecological), or, more rarely, by hemolytic anemia. In the case of the latter, genetic (sickle cell anemia and thalassemia) or autoimmune diseases are responsible for the body’s destruction of red blood cells.

What causes iron deficiency in infants?

As we have seen, nearly one in 2 children worldwide suffers from anemia, and iron deficiency is the main cause. There are three main causes of iron deficiency in infants:

Poor iron intake

Poor iron intake is a sign of poor nutrition, or even malnutrition. This is why anemia is so prevalent in low-income countries, rural populations and poor families with low levels of education.

Children’s diets are often low in iron. This is particularly the case when they drink a lot of non-maternal, non-enriched milk (e.g. conventional cow’s milk). This provides an insufficient supply of iron for the body. In fact, children over 2 years of age who still drink from a bottle are more likely to develop anemia.

As a guide, a child aged 7 to 12 months needs a daily iron intake of 11mg, and 7mg from 1 to 3 years.

To visualize what these quantities represent, here are some foods with their iron content for a given quantity:

Poor iron assimilation

Iron uptake varies according to the origin of the micronutrient. A distinction is made between heme iron found in meat and non-heme iron found in plants. The body assimilates heme iron better. So, if a child’s only source of iron is plant-based, a higher quantity will be needed to compensate for its poor assimilation.

A need for higher-than-normal iron intake

Finally, some children have a higher-than-normal need for iron. This is the case for premature babies, whose production of red blood cells is slower than that of full-term babies. They are more prone to iron deficiency. A high intake of this micronutrient helps to alleviate this problem by stimulating the production of hemoglobin-rich red blood cells.

Preventing and treating anemia in infants by limiting iron deficiency

Preventing infantile anemia

Preventing and treating anemia in infants is essential, as it can have serious consequences for their health. If anemia is severe, symptoms such as swollen hands and feet, fainting, rapid heartbeat, bruising and headaches can occur. In severe cases, it can lead to cognitive and motor deficits, and even disabilities.

Preventing anemia in infants involves ensuring a good diet, with adequate quantities and quality of micronutrients, as well as an appropriate intake. For premature infants, regular iron supplementation is recommended until the child’s first birthday.

To date, the nutritional solutions available to prevent infantile anemia are iron-enriched products. These include breakfast and snack products such as cereals, energy bars, cookies, milk, fruit juice, etc. They have been developed for children, whose micronutrient requirements are high during growth.

The growing attention paid to iron deficiency in recent years has led to the emergence of a wide range of nutritional solutions.

In many cases, iron-fortified foods are also enriched with calcium and vitamins, and are designed to address public health issues such as iron deficiency and anemia.

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Treating anemia in infants

If anemia nevertheless occurs, and is due to iron deficiency, the treatment often involves oral supplementation in syrup form. This is usually combined with a vitamin C supplement, since vitamin C enables iron to bind in the body, improving its absorption.

When supplementation fails, infusions or even transfusions are considered, although in most cases a balanced diet will suffice.

Anemia is a public health issue, particularly for women and children. Its main cause is iron deficiency, due to insufficient iron intake, sometimes combined with poor assimilation. This can have serious health consequences, including cognitive and motor deficiencies in children. Preventing and treating anemia in infants is therefore a major challenge. This mainly involves a balanced diet and iron supplementation. This is why iron-enriched foods for children are flourishing. The arrival on the market of these nutritional solutions opens up a vast field of possible innovations in response to this global health issue. Our specialized healthcare team is ready to support you in the development of your medical nutrition projects. Don’t hesitate to contact our team!

About the author,

Agnès, Consultant in Alcimed’s Health team in France.