Anemia is a deficiency in red blood cells, also called “low hemoglobin”. Symptoms of anemia include fatigue, pale skin color, fast heart rate, or may have no symptoms at all. It is common practice at either the 12 month or 15 month visit for your pediatrician to check your child for anemia. This is usually done in the office with a finger poke, like a diabetic testing their sugar. 

Normal range for hemoglobin:

• Age 6-24 months is 11-13
• Age 2-6 years is 11.5-13.5
• Age 6-12 years is 12-15
• Age 12-18 years:
  • Males is 13-15.5 
  • Females is 11.5-15

 There can be multiple causes of anemia. Drinking too much whole milk (over 24oz per day) is a very common reason for toddlers to be anemic. This is due to the fact that the calcium in dairy products inhibits the absorption of iron in the gut. 

Another common cause of anemia in children is insufficient intake of iron containing foods. High iron containing foods include spinach and other leafy green vegetables, red meat, lentils, beans, chickpeas, soybeans (edamame), peas, quinoa, tofu, broccoli, canned tuna, and dark chocolate. 

Here’s a meatball recipe I suggest for a big blast of iron: 1 lb lean ground beef, 1 lb cooked lentils, 10oz bag spinach- cooked, 2 eggs, ½ cup bread crumbs (even tear up 2 slices of sandwich bread instead), ¼ cup ketchup, seasonings of your choice (I use Worcestershire sauce, garlic powder, salt & pepper). Mix all ingredients together with your hands, form into 2 inch meatballs, and bake in 350 degree oven for 20 minutes. Don’t forget about your old trusty iron skillet! Lug that heavy pan out and start using it often to pan sauté your meat and vegetables to add iron into other foods you are already cooking.

 There are other more rare causes of anemia including inherited red blood cell defects such as sickle cell disease and thalassemia and serious infections. 

If your child has moderate to severe anemia, they may require a prescription iron supplement, but I’ll warn you, it is one of the nastiest tasting medications I have ever tried. (In pediatric residency, we had the opportunity to “taste test” about 20 different medications commonly prescribed, so we understand exactly what the children’s medications taste like.) In lieu of this, our hematology clinic offers iron infusions if deemed necessary. Warning, even taking a daily over the counter multivitamin will not prevent or treat anemia in a picky eater, as most vitamins do not contain iron.

 Talk with your pediatrician if you are concerned your child may be anemic, especially out of the 12-15 month age range when they are usually checked.

Sickle Cell Disease (SCD) causes an abnormal shape of the red blood cells. The red blood cells are shaped like crescents instead of circles. They don’t last long and they can get stuck in the blood vessels, which blocks the blood flow, often resulting in pain and organ damage.

SCD is a group of inherited red blood disorders affecting an important protein in the red blood cell. This protein is called hemoglobin. Hemoglobin helps the red blood cell to carry oxygen to all the different parts of the body. In sickle cell disease, the body produces one or more abnormal types of hemoglobin. This means that the ability of the red blood cell to carry oxygen to all parts of the body is changed. Sickle Cell Disease is a lifelong illness that can result in serious health problems.

There are different forms of Sickle cell disease which are named depending on whether a person inherits a sickle cell trait from each parent or if the person inherits sickle cell trait from one parent and a different abnormal hemoglobin trait from the other parent. Some common types of sickle cell disease include SS disease also known as Sickle Cell Anemia, Sickle Hemoglobin C disease, and Sickle Beta Thalassemia.

Sickle cell disease affects about 100,000 people nationwide. Among the many misconceptions of SCD, African Americans are not the only race affected by the disease. While the African American race makes up a reported 60 to 80 percent of Americans diagnosed, people of East Indian, Middle Eastern, Hispanic and Mediterranean descent may also be affected.

The cure for SCD lies in bone marrow transplants, and while siblings typically are the best matches for this disease, anyone willing to donate can be tested.

Donating bone marrow requires less than 5% of bone marrow cells and is typically taken from the hip of the donor or through a non-surgical procedure in which it is collected through an IV.

While Stem cell transplant can provide a cure for Sickle Cell Disease, it is not an easy cure. There can be many complications. Some patients may not engraft, meaning the donor cells may not grow, and the patient’s own cell grow back instead or a second transplant is needed. There can also be challenges with finding a donor. So unfortunately we cannot consider stem cell transplant to be a universal cure that is available to all with the disease. More research for a universal cure is needed. There are small trials with gene therapy being done currently which I hope will prove successful to offer the chance of cure to even more people with Sickle Cell Disease.

The Sickle Cell Program at Cook Children's Sickle Cell Center serves more than 400 children annually across northern Texas and adjoining states. The program offers testing, diagnosis and treatment for the many types of sickle cell disease. Research is also an important part of the program as the team seeks new ways to treat and prevent the many complications that can occur as a result of this disease. Click here to learn more.

Cook Children's Hematology and Oncology Center is actively involved in sickle cell disease research, including stem cell transplantation. The recognized team of researchers work with leading organizations across the U.S. and around the globe to find solutions to treating, preventing and curing the disease. As a research facility, Cook Children's also has a number of clinical trials available and we are able to match our patients to trials at other facilities. 

Other resources on this topic:

• Sickle Cell Disease
• Hematopietic Stem Cell Transplantation
• Clinical Trial Drug Reduces Pain Of Sickle Cell Patients
• Brotherly Love: Siblings Receive Bone Marros Transplant From Older Brothers
• 'She Takes It and Keeps On Moving.' Child Battles Four Major Diagnosis and Two Surgeries in 5 Years
• The Greatest Gift: Bone Marrow Donors Tell Their Stories
• 4 Reasons Why Pediatricians Recommend Public Cord Banking
• Warning Signs of Pediatric Stroke
• Living With Sickle Cell