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).

Radiation therapy is the use of special x-ray beams to treat tumors. Some tumors respond well to this treatment, while others do not. So it is not the right treatment choice for all types of tumors. Radiation therapy is often used in combination with surgery.

Oncologists work together with radiation oncologists at Abbott Northwestern in Minneapolis and United Hospital in St. Paul. Together, they determine the exact location of the tumor using CT and MRI scans. Then special X-rays focused from several angles on and around the tumor are used to destroy the remains of a tumor. The X-ray beams can travel deep into tissue, through bone and other structures to reach the tumor. The technology for radiation treatment has changed remarkably in recent years. Because we can better target the precise location of tumors, we are able to limit damage to healthy areas close to the tumor. This means fewer side effects from the treatment, both immediate and long term or later, years after treatment.

Radiation therapy often produces side effects such as temporary hair loss (also called alopecia), nausea and vomiting, headache and fatigue. We will work with you and your child to reduce any side effects experienced from treatment.

Depending on the site of the treatment, long-term side effects also are possible. Physical growth, hormone function and cognitive (learning) function are a few possible areas where problems may occur later after treatment. There also is a risk of second cancers developing in the radiation site.

Our physicians communicate and consult with their colleagues from around the country, ensuring your child receives the care they need, even if it's not available at Children's.

Types of Radiation Available

External Beam Therapy

This form of radiation uses treatment machines called linear accelerators. These machines produce ionizing radiation to destroy cancer cells externally to a defined target area surrounding the tumor.


This treatment applies radiation internally directly on the tumor location. Brachytherapy delivers a higher dose of radiation to help destroy the main mass of tumor cells in a more concentrated fashion.

Stereotactic Radiosurgery

This is a one-time, noninvasive procedure that administers precise, high doses of radiation to cranial abnormalities. Stereotactic radiosurgery uses computer imaging to precisely locate the lesions in three dimensions.

Fractionated Stereotactic Radiosurgery

This treatment method delivers radiation to cranial tumors over a number of days, reducing radiation exposure of nearby structures. The procedure is important for treating lesions near radiosensitive tissues.

Stereotactic Body Radiation Therapy

This treatment method delivers radiation to isolated tumors in the body over a shorter course of treatment, reducing radiation exposure to nearby structures. The treatment course is shorter in duration.

3D Conformal Radiation Therapy

This external treatment has the ability to identify in three-dimensions the tumor and surrounding normal tissues and customize the radiation beams.

Intensity Modulated Radiation Therapy

In this form of external treatment, the radiation beam intensity is altered to 'paint' with radiation doses for the desired concentration.

Image Guided Radiation Therapy

This type of imaging occurs prior to daily treatment and matches structures in the body exactly with the CT images that were taken for treatment planning and sets the radiation therapy target at each treatment.

Rapid Arc Intensity Modulated Radiation Therapy (IMRT)

Some tumors can be treated with Rapid Arc treatment delivery where IMRT treatment is delivered in single or multiple arc rotations of the machine around the patient.

3 Tesla MRI System

An MRI, or magnetic resonance imaging, system allows physicians to watch blood and electrical impulses travel through the brain. The 3 Tesla MRI System, available at Children's through a partnership with Abbott Northwestern Hospital, is twice as powerful and faster than standard MRI machines. The system provides detailed views of anatomy as well as metabolic functioning. For example, prior to brain tumor surgery, 3 Tesla MRI images allow the neurosurgery team to better map the tumor and determine its relationship with areas of the brain involved in important functions such as speech and movement. After surgery or tumor treatment, 3 Tesla MRI images provide the team with a dynamic portrait of the metabolic and physical changes happening in the tumor.

Oncology Surgery

At Children's, our cancer surgery outcomes are some of the best in the U.S., according to data from the Pediatric Health Information Systems (PHIS) database. Oncology surgery team members perform state-of-the-art procedures , such as intra-operative-MRI-assisted surgery and minimally invasive surgery.

Oncologists partner with pediatric surgeons, such as pediatric urology surgeons, neurosurgeons and ENT surgeons, depending on your child's unique needs. More than 1,200 oncology surgeries are performed each year, making Children's the largest provider of cancer surgeries in the Upper Midwest. Other invasive procedures, such as biopsies, and PICC line placement, are performed frequently at Children's as well. For more information, visit Children's cancer and blood disorders program page.

Our goal is to provide your child or teen with the best possible surgery experience. At Children's:

  • Surgery is performed by a team of surgery and oncology professionals who specialize in the unique needs of children.
  • Pain is managed by a world-renowned interdisciplinary pain management team.
  • The health care team considers you to be an essential part of your child's care team, because you know your child best.
  • Oncologic surgery is performed at the following Children's locations:
    • Children's - Minneapolis
    • Children's - St. Paul

Some procedures may take place in the interventional radiology suites at Abbott Northwestern Hospital in Minneapolis or at United Hospital in St. Paul.

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 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).