Externally Peer Reviewed Improved nutrition has eased the problem of childhood anemia in the United States. However, certain groups of children, particularly infants and adolescent girls, remain at significant risk. Factors that place infants at high risk include low socioeconomic status, consumption of cow's milk before age 1 year, consumption of formula not fortified with iron, and low birth weight. Untreated anemia can lead to fatigue, apathy, impairment of growth and development, and decreased resistance to infection.
Iron deficiency is the most common cause of anemia in children and adolescents.
Hemoglobinopathies, such as sickle cell disease and thalassemia, are also significant causes. See chapters 8 and 27 for information on screening for hemoglobinopathies in newborns and adults, respectively. Hemoglobin concentration screening should be performed between 6 and 12 months of age for infants in high-risk groups. There is conflicting and insufficient evidence to recommend for or against inclusion or exclusion of routine hemoglobin measurements at 6 to 12 months of age in normal infants. The microhematocrit method yields slightly higher values and is somewhat less sensitive than the automated cell counter method.