Anemia is a condition in which there is an abnormally low number of red blood cells, decreasing the blood's ability to carry oxygen to the body's tissues. Although most children with anemia do not show any signs of it, they may be pale or have a lower energy level than normal.

In young children, the most common cause of anemia is an inadequate amount of iron in their diets. It may also be caused by an increased destruction of the red blood cells or by bleeding. Adolescent females may become anemic after starting menstruation.

Your doctor will probably check for anemia around your child's first birthday. Prior to that, the infant's intake of iron from breast milk or formula is usually adequate to prevent anemia. Mothers who breast-feed should be sure to take enough iron themselves.

Left untreated, children with anemia may experience slow growth, delayed development or low energy levels.

Because iron deficiency is the most likely cause of anemia, your physician will probably recommend a diet of iron-rich foods for your child and then recheck the blood several months later. Foods with a high-iron content include all kinds of meat, beans, peas, broccoli, spinach, dried fruits (raisins, prunes, dates and apricots,) egg yolks, molasses and enriched cereals, breads and pastas.

Cow's milk does not contain any iron, which is one reason not to give it to children under 1 year of age. For older children, you should be careful not to allow your child to drink so much milk that his appetite for the iron-rich foods is decreased.

The body can use iron better if vitamin C is consumed at the same time. Foods high in vitamin C include citrus fruits (oranges and grapefruits), strawberries, cantaloupe, tomatoes, green peppers and broccoli.

Children with more severe anemia may also require iron supplements either as iron alone or combined with a multivitamin. Iron supplements may change your child's stools to a greenish-black color but should not cause constipation.

Too much iron can be dangerous, so you should not give iron supplements to your child without a doctor's recommendation, and as with any medication, remember to keep the supplements out of your child's reach.

Dr. Linda Burk works with new River Valley Pediatrics in Blacksburg and Radford.