Treating Anemia in the Newborn

Your newborn has been diagnosed with anemia. This means the baby’s blood contains fewer red blood cells than normal. Red blood cells carry oxygen throughout the body. When a baby has anemia, the body doesn’t get enough oxygen. As a result, the baby feels tired and has less energy. Many babies have mild anemia within a few months after birth. These cases don’t require treatment. But your baby’s anemia is more severe. It must be treated to bring the red blood cell count back up.

Signs of anemia in a newborn

  • Short periods of not breathing (apnea)

  • Fast breathing

  • Pale skin

  • Poor weight gain

  • Decreased activity

  • Fast heart rate (tachycardia)

  • Severe swelling (hydrops)

Causes of anemia

Your baby’s anemia is likely caused by one of these problems:

  • Blood loss. This is a common cause of anemia in babies in the NICU (neonatal intensive care unit). This is because blood must be taken from the baby often so certain tests can be done. A baby who has a hemorrhage (internal bleeding) could also become anemic. In some cases, some of the baby’s blood moves into the mother’s bloodstream during pregnancy. As a result, the baby has less blood. This is called a fetal-maternal transfusion. Blood loss can also occur in twins if one twin got less blood than the other during pregnancy (called a twin-to-twin transfusion).

  • Low red blood cell production. This occurs if the baby doesn’t get enough iron (a nutrient that helps build red blood cells). Normally, the baby’s body stores oxygen during the last months of pregnancy. When a baby is born early, less iron is stored, so red blood cell production may be low.

  • Shortened red blood cell life (hemolysis). This means the baby’s red blood cells aren’t living as long as they’re supposed to.  In some newborns, it happens because the baby’s blood type is incompatible with the mother’s blood type. During pregnancy, the mother’s body made substances called antibodies that fought against the baby’s red blood cells. These antibodies are now in the baby’s blood. As a result, the baby’s red blood cells don’t live as long. Hemolysis can have other causes, too. Talk to the doctor about the cause of your baby’s hemolysis.

Treatments for anemia

  • A blood transfusion puts healthy donor blood into the baby’s body. This is done through an IV (intravenous) line. The donor blood helps bring the baby’s red blood cell count back to normal.

  • Medication may be given to the baby through an IV line or by injection. The medication prompts the baby’s body to make more red blood cells.

What are the long-term effects?

Once treated, anemia does not cause long-term complications for most babies. Talk to the doctor about how your baby is likely to progress.


Special notes for parents of preemies

Anemia of prematurity (AOP) often occurs in preemies born before 35 weeks’ gestation. This happens because the baby was born before his red blood cell production matured. The earlier the baby is born, the more likely he is to develop anemia of prematurity. When a preemie is discharged from the hospital, an iron supplement is often prescribed. This helps keep the baby’s red blood cell count up, to prevent anemia from returning. Your baby’s doctor will tell you more.


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