A Parent's Guide to the NICU

Anemia

What is anemia?

Anemia is having too few red blood cells. Red blood cells carry oxygen to the body.

How do the doctors know if my baby has anemia?

Two laboratory tests, hematocrit and hemoglobin, are used to determine red blood cells in blood. The value for the hematocrit is usually about three times larger than the hemoglobin.

How do my baby's doctors know if my baby is making blood?

A blood test called the Reticulocyte Count measures the percent of newly made red blood cells.

Why do premature babies get anemic?

They become anemic because:

• their red blood cells have a shorter life than red blood cells of adults. This may be exaggerated if the baby's blood type is different than the mother's.
• they make few new red blood cells in the first few weeks of life
• blood is taken from the baby to do necessary laboratory tests. This is the most common reason for premature infants to need transfusions or treatment for anemia.

How is anemia treated?

Anemia is usually treated by transfusions of red blood cells obtained from the blood bank. This is the only way to increase the number of red blood cells rapidly.

Anemia can also be treated by erythropoietin. This is a drug similar to the substance the body normally produces to increase the number of red blood cells. It works slowly over days to weeks. It is not useful if the anemia needs to be treated more rapidly.

Anemia does not always need to be treated if it is not severe and if the baby is not sick or having frequent laboratory tests. Eventually the baby will make more red blood cells.

Later, as the baby grows, s/he may need an additional source of iron. This may be an iron fortified formula, vitamins with iron, or iron drops. Iron is needed by the body to make red blood cells.

Can my baby have my blood for transfusions?

Women who have recently given birth are not usually considered for blood donation because they have already lost blood with the delivery of the baby.

Blood for a baby must be from someone with a compatible blood type and it must pass several screens for exposures to certain viruses. The majority of potential donors are not acceptable for these reasons. Even if you give blood regularly, your blood may not be acceptable for your baby.

If you are interested in finding out if you, a friend, or a relative are an acceptable donor, ask your baby's doctor if the hospital has a directed donor program.

How many blood transfusions will my baby need?

That depends on how small and how sick your baby is. Very tiny infants with respiratory problems may require transfusions as often as once a day. Larger, healthy premature babies may never need a transfusion.