Clinical Services

What is iron deficiency anemia?

Iron deficiency anemia is the most common type of anemia in children. Iron is an element that is needed to form hemoglobin. Hemoglobin is important in carrying oxygen from the lungs to the cells of the body. Iron usually is absorbed from the gastrointestinal tract. Iron then is stored in the body in the form of hemoglobin. Iron also is stored as ferritin and hemosiderin in the bone marrow, spleen and liver.

The diagnosis and treatment of iron deficiency is important because iron deficiency causes anemia and also because iron deficiency can affect a child's neuro-psychological development. That is, iron deficiency can affect a child's school performance, attention span, ability to learn, and other brain functions.

What are the causes of iron deficiency?

Iron deficiency can be caused by:

  • Blood loss. This can occur through the gastrointestinal or urinary tract or with heavy menstrual periods or an injury.
  • Inadequate diet. Iron is obtained from the diet and is absorbed through the intestines. The human body absorbs only about 5-10% of the iron that is ingested.
  • Body changes. There are certain times in life when rapid growth and resulting increased red blood cell production increases the need for iron. This typically occurs in the first two to four years of life and during adolescence. Pregnancy and breastfeeding also increase the need for iron to produce red blood cells. During these times it is difficult to obtain enough iron from a normal diet.
  • Gastrointestinal tract abnormalities. Some people have an abnormal gastrointestinal tract because of surgery or a gastrointestinal disease that prevents their intestines from absorbing enough iron from their diet. In addition, the gastrointestinal tract can be a site of blood loss.

What are the signs and symptoms of iron deficiency anemia?

The signs and symptoms are the same as those of other types of anemia. In addition, iron deficiency anemia may cause pica, a desire to eat peculiar substances such as dirt or ice.

How is iron deficiency anemia diagnosed?

Usually, anemia can be diagnosed through a blood test. Anemia is diagnosed by finding decreased hemoglobin and hematocrit levels in the blood. In some cases, an examination of the blood will show that your child's red blood cells are smaller than normal. In these cases, iron deficiency usually is considered to be the cause of the anemia. To confirm the diagnosis, a blood test that examines your child's iron profile and/or ferritin is performed.

Other laboratory studies and x-rays may be necessary to monitor possible blood loss and/or other effects that the anemia is having on your child's body.

How is iron deficiency anemia treated?

The treatment of iron deficiency anemia depends upon your child's age, the severity of the anemia and the cause of the iron deficiency. Your child's provider may recommend an iron-rich diet, iron supplementation (either by mouth or intravenously) or a blood transfusion.

It is important that a child with iron deficiency anemia be followed until they have a normal hemoglobin and iron stores in the body have been replenished. After this, the child should be monitored to ensure the iron deficiency anemia does not recur.

About treatment for iron deficiency anemia at Children's

Children's Cancer and Blood Disorders program achieves outcomes that rank among the top national programs and cares for more than two-thirds of Minnesota children and adolescents with blood disorders. In the program, families coping with iron deficiency anemia have access to the newest and most promising treatments and receive care spearheaded and coordinated by a board-certified hematologist/oncologist.

Contact us

If you are a family member looking for a Children's hematologist or oncologist or wanting to schedule an appointment, call the outpatient clinic at Children's – Minneapolis at (612) 813-5940

If you are a health professional looking for consultation or referral information, please call Children's Physician Access at 1-866-755-2121 (toll-free).

State-of-the-art imaging can help diagnose your child or teen's condition and define the best possible course for treatment. Pediatric-trained radiologists work in concert with hematologists/oncologists to provide tests recommended for your child.

A special focus at Children's is helping your child or teen cope with discomfort that can occur with some tests. We are nationally recognized for our efforts to reduce the severity of side effects that may happen during procedures and treatment.

At Children's, we believe that no child should suffer needless pain. We are known for aggressive management of pain and side effects. Our Pain and Palliative Care Program strives to control acute, chronic and complex procedural pain in both the outpatient and inpatient settings. Our program is nationally recognized and led by our world-renowned pediatric pain management specialist.

This may involve safe sedation, for example, through Children's award-winning nitrous oxide program, the use of imagery and pain control techniques taught by child life specialists, or other services provided through the integrative medicine department. If you have questions or ideas about how to help your child cope with medical procedures, we encourage you to talk with your nurse, nurse practitioner or physician.

Some common tests performed for concerns about cancer or blood disorder diagnosis include:

  • Biopsies. A biopsy is a tissue sample that is examined under a microscope to determine whether abnormal cells are present. There are several types of biopsies. A needle biopsy is taken by inserting a hollow needle under the skin. A sample of tissue is drawn into the hollow part of the needle. Other types of biopsies are removed through a small incision in the skin or through a larger incision made during surgery. Sedation or general anesthesia is used when biopsies are taken.
  • Blood tests. Blood tests are samples of blood used to provide information about the kinds and numbers of cells in the blood. The results help determine diagnosis and treatment.
  • Bone marrow aspiration and biopsy. In the center of bones is a substance called bone marrow. Blood cells and platelets are manufactured in bone marrow. In a bone marrow aspiration, a needle is inserted in the hip and a syringe is used to withdraw a bone marrow sample. If a biopsy is performed, a small sliver of bone is taken from the same area. A bone marrow sample can reveal problems with the number or quality of blood cells and platelets being made or the presence of cancer cells. Sedation is used when a bone marrow aspiration is performed.
  • Bone scan. A bone scan can detect infections, tumors, weaknesses, and other problems in your child's bones. Your child will receive a small amount of radioactive dye through an intravenous (IV) line before the test begins. In some cases, sedation is used during bone scans to help a child lie still.
  • CT scans. A computed tomography (CT) scan is an x-ray that produces more detailed images of internal organs, bones, and other tissues than a regular x-ray can.
  • Genetic tests. There are many types of genetic tests, which typically are performed as part of care provided in conjunction with Children's genetic program. Usually the tests are performed on a sample of blood, hair, skin, saliva, or amniotic fluid (the fluid that surrounds a fetus during pregnancy.) Laboratory professionals use the samples to look for changes in chromosomes, DNA, or proteins.
  • Lumbar puncture. A lumbar puncture, also known as a spinal tap, involves a needle inserted between the vertebra of the spine in order to collect a sample of cerebrospinal fluid. This fluid surrounds the brain and spinal cord. Cerebrospinal fluid is helpful in determining whether cancer is present and/or how cancer treatment is progressing. Sedation or sometimes anesthesia is used for lumbar punctures.
  • Magnetoencephalogram (MEG) is a non-invasive test that maps the brain's electrical activity. For people with seizures it can pinpoint where the seizures are coming from and plot the areas onto a picture of your brain from an MRI. This allows neurologists to locate important areas of brain functions including motor, sensory and language. This kind of mapping is especially important when removing brain tumors.
  • MRIs. Magnetic resonance imaging (MRI) provides detailed images of the body and more clearly shows the soft tissues of the body. At Children's, hematologists and oncologists work closely with radiologists to provide fast, highly-detailed images, which minimizes the time children must remain still and hold their breath during the MRI exam. Intra-operative MRI and 3 Tesla MRI are also available at Children's. Read a story about Intra-operative MRI at Children's in Children's Practice Magazine.
  • Functional MRI. This is a type of non-invasive, specialized brain and body scan is used to map cell activity in the brain or spinal cord by imaging changes in blood flow. This is done before tumor removal surgery to pinpoint the location of important brain functions close to the tumor.
  • PET scans. A positron emission tomography (PET) scan can help determine how well organs and tissues are functioning by highlighting chemical activity in the body in light or dark colors on a PET image. PET scans also can help determine whether cancer has spread to another part of the body. Often, PET and CT scans are performed together.
  • Video Electroencephalography (Video EEG). During this test used to learn more about seizure activity, an EEG is done while being watched by a video camera. It is a painless, safe way to record the electrical activity in the brain and the child's physical activity at the same time.
  • X-rays. X-rays play an important role in detecting many types of cancer and can help determine whether cancer has spread to another part of the body.

Contact us

If you are a family member looking for a Children's hematologist/oncologist or wanting to schedule an appointment, call the outpatient clinic at Children's – Minneapolis at (612) 813-5940.

If you are a health professional looking for consultation or referral information, please call Children's Physician Access at 1-866-755-2121 (toll-free).

State-of-the-art tests, procedures and imaging equipment and specially trained pediatric technicians can help diagnose your child or teen’s condition and define the best possible course for treatment. Pediatric-trained radiologists, laboratory technicians and others work together with the hematologist to provide tests and interpret the results.

A special focus at Children’s is helping your child or teen cope with discomfort that can occur with some tests. This may involve safe sedation (for example, through Children’s award-winning nitrous oxide program), the use of imagery and pain control techniques taught by child life specialists, or other services provided through the integrative medicine department (link coming soon!). If you have questions or suggestions about how to help your child cope with medical procedures, we encourage you to talk to your child’s physician or nurse.

Common tests and procedures performed to collect information about blood disorders include:

  • Blood tests. Blood tests can provide information about the kinds and numbers of cells in the blood.
  • Bone marrow aspiration and biopsy. In the center of bones is a substance called bone marrow. Blood cells and platelets are manufactured in bone marrow. In a bone marrow aspiration, a needle is inserted in the hip (or occasionally into a different area of the body) and a syringe is used to withdraw a bone marrow sample. If a biopsy is performed, a small sliver of bone is taken from the same insertion site. A bone marrow sample can reveal problems with the number or quality of blood cells and platelets being made. Sedation is used when a bone marrow aspiration is performed.
  • CT scans (CT). A computed tomography (CT) scan is an x-ray that produces more detailed images of internal organs, bones, and other tissues than a regular x-ray can.
  • Echocardiogram (ECHO). An ECHO is a safe, painless test that looks at the strength and function of the heart. It can determine some problems of the heart. The test used sound waves, like the ultrasound, to create a picture of the heart. The person doing the test will hold a small instrument (transducer) to take the pictures.
  • Electrocardiogram (ECG or EKG). An ECG is a test measuring the rhythm of the heart by using several leads (stickers with a metal center) placed on different parts of your body. These leads are used to monitor the rhythm of the heart. An EKG does not hurt. Sometimes it lasts 15 minutes, other times the rhythms may be monitored for several days using a small device worn by the person to collect the information.
  • Genetic tests. There are many types of genetic tests, which typically are performed as part of care provided in conjunction with Children’s genetic program. Usually the tests are performed on a sample of blood, hair, skin, saliva, or amniotic fluid (the fluid that surrounds a fetus during pregnancy.) Laboratory professionals use the samples to look for changes in chromosomes, DNA, or proteins.
  • Magnetic Resonance Angiogram (MRA). A MRA is a type of MRI that is designed to examine the veins, arteries and the blood flowing within them. This test is often used in patients that have sickle cell disease to look at arteries of the neck and brain for any narrowing or plaque build up that could lead to a stroke. Although the test is not painful or invasive, the child needs to lie very still while the pictures are being taken. Sometimes children need to have medicine to sedate them during the test so they will not move. A MRI can take between 30 minutes and 2 hours to complete.
  • Magnetic Resonance Imaging (MRI). Magnetic resonance imaging (MRI) provides detailed images and more clearly shows the soft tissues of the body. At Children’s, the hematologist and radiologist work together to provide fast, highly-detailed images, which minimizes the time children must remain still and hold their breath during the MRI exam. Although the test is not painful or invasive, the child needs to lie very still while the pictures are being taken. Sometimes children need to have medicine to sedate them during the test so they will not move. A MRI can take between 30 minutes and 2 hours to complete. Intra-operative MRI and 3 Tesla MRI are specialized MRIs also available at Children’s.
  • Transcranial Doppler Ultrasound (TCD). TCD’s are a safe, painless way to measure blood flow in the brain. Some children, such as those with sickle cell disease, have a history of high blood flow, or velocities in their brains. This puts them at risk for strokes. Periodic measurements by TCD allow us to monitor the brain’s blood flow for any changes or identify if strokes have happened. A TCD uses sound waves, similar to ultrasound, to measure the velocity of the blood. It is painless and takes about 45 minutes to an hour.
  • Ultra Sounds. An ultrasound is a safe, painless test that uses sound waves to produce pictures of body organs and tissues. No radiation is produced.

If you are a family member looking for a Children's hematologist/oncologist or wanting to schedule an appointment, call the outpatient clinic at Children's – Minneapolis at (612) 813-5940.

If you are a health professional looking for consultation or referral information, please call Children's Physician Access at 1-866-755-2121 (toll-free).