1068
Request Call Back
Contact
1068
Is Your Child Just Tired, or Could It Be Anemia? A Paediatric Haematologist’s Guide
Published on: Oct 05, 2026
TABLE OF CONTENTS
As a pediatric haematologist, I often see parents asking questions like: "Why does my child suddenly does not want to play?" or "My child has been looking pale lately, is something wrong?"
Often, the answer is anaemia. Anaemia is not a standalone disease; it is a sign that something is preventing the body from carrying enough oxygen to its tissues. Here is what every parent should know about this condition, its signs and symptoms and underlying causes.
Red blood cells contain a protein called hemoglobin, which carry oxygen from the lungs to the brain, muscles, heart, and other organs.
When a child has anemia, they either don't have enough red blood cells, or those red blood cells don't have enough functional hemoglobin. Without adequate oxygen delivery, organs work harder, leading to the symptoms.
Unusual Fatigue and Low Stamina: Child tires quickly at the playground, sits out during sports, or falls asleep during routine car rides.
Paleness (Pallor): The lower eyelids (conjunctiva), the inner lining of the lips, the tongue, and the nail beds become whitish which are otherwise pink.
Irritability and Mood Changes: Because of reduced oxygen delivery to the brain, children frequently become fussy, clingy, irritable or prone to frequent meltdowns.
Rapid Heartbeat or Fast Breathing: During everyday play, parents can notice their child’s heart racing or chest moving faster than usual.
Pica (Craving Non-Food Items): A classic sign of iron deficiency. Children may compulsively eat ice, dirt, chalk, clay, or freezer frost.
Poor Appetite or Poor Weight Gain: Many children with anemia become picky eaters.
Common Causes of Childhood Anemia
1. Nutritional Deficiencies (The Most Common Culprit)
Iron Deficiency: Most common cause worldwide. We commonly see this in toddlers who drink excessive amounts of cow's milk. Cow's milk is low in iron, and can irritate the gut lining. We also see it in adolescents undergoing rapid growth spurts. Vitamin Deficiencies: Insufficient Vitamin B12 or folic acid intake
2. Inherited Blood Conditions (Hemoglobinopathies & Membrane Disorders): Thalassemia Trait or Disease: A genetic alteration affecting hemoglobin production.
Sickle Cell Disease: Genetic variants cause red blood cells to deform into sickle shapes, which break down prematurely and block the small blood vessels.
G6PD Deficiency: An enzyme deficiency that makes red blood cells fragile and prone to sudden breakdown (hemolysis) when exposed to certain infections, medications, or fava beans.
3. Blood Loss
Gastrointestinal Loss: Chronic, small amounts of microscopic bleeding from cow's milk protein allergy, intestinal parasites, or inflammatory bowel conditions.
Heavy Menstrual Bleeding: Common in teenage girls during the first few years after starting their period.
4. Bone Marrow and Systemic Conditions
Anemia of Chronic Disease: Long-standing infections, autoimmune conditions, or kidney diseases can suppress bone marrow function.
Bone Marrow Failure or Malignancy: Rare conditions like aplastic anemia or leukemia, where the bone marrow stops producing blood cells correctly. These cases almost always present alongside other symptoms, such as unexplained bruising, frequent fevers, or recurrent infections.
When to See Your Doctor
If you suspect your child is anaemic, schedule an evaluation with a paediatric haematologist.
A Quick Doctor's Note: Never start your child on over-the-counter iron supplements without a confirmed blood test. Giving iron to a child with thalassemia or non-nutritional anemia can lead to dangerous iron overload, and accidental iron overdoses are a medical emergency in young children.
