Anemia of Prematurity: What Parents Need to Know
Anemia of prematurity is a common condition affecting preterm infants, yet many parents are unfamiliar with it until they hear it mentioned by their baby’s NICU care team. It occurs when a premature baby has lower-than-normal red blood cell levels, which can impact oxygen delivery throughout the body. While the term “anemia” might sound concerning, it is a well-understood condition that NICU teams carefully monitor and treat as needed.
Understanding anemia of prematurity can help parents feel more informed and prepared when discussing their baby’s care plan.
What Causes Anemia of Prematurity?
All newborns experience a natural decrease in red blood cells after birth, but premature infants are more affected due to several factors:
Missed Final Weeks of Blood Production – During the last trimester of pregnancy, babies build up iron stores and produce red blood cells at a rapid rate. Preterm infants miss out on this crucial period, leaving them with fewer reserves.
Frequent Blood Draws in the NICU – Premature infants require routine blood tests for monitoring, but because they have a smaller total blood volume, even small blood draws can contribute to anemia.
Immature Bone Marrow Function – The bone marrow produces red blood cells, but in preterm babies, this function is still developing and may take time to become fully efficient.
Low Levels of Erythropoietin (EPO) – EPO is a hormone that stimulates red blood cell production. Preemies naturally produce less EPO, making it harder for their bodies to replenish red blood cells.
Signs and Symptoms of Anemia in Preemies
Anemia of prematurity often develops gradually, and NICU teams routinely monitor a baby’s hemoglobin levels. However, some common signs that may indicate anemia include:
Pale skin – A noticeable change in complexion, appearing paler than usual.
Increased apnea or bradycardia episodes – More frequent pauses in breathing or drops in heart rate.
Fatigue or decreased activity – Reduced movement and overall alertness.
Difficulty feeding – Less energy for sucking and swallowing effectively.
Because these symptoms can be subtle, medical teams rely on regular blood tests to track a baby’s red blood cell levels and determine if intervention is needed.
How is Anemia of Prematurity Treated?
The treatment approach for anemia of prematurity depends on the severity of the condition and how well the baby is tolerating it. Some cases resolve on their own as the baby matures, while others require medical support.
1. Iron Supplementation
Iron is essential for red blood cell production, and preterm infants often need additional iron beyond what is naturally available in breast milk or formula. Many NICUs provide iron supplements through feeding tubes or fortify the baby’s milk to support red blood cell development.
2. Red Blood Cell Transfusions
If a baby’s anemia is severe or causing complications such as difficulty breathing, a blood transfusion may be necessary. This common NICU procedure restores red blood cell levels, improving oxygen delivery and stability. While the idea of a transfusion can be concerning for parents, it is a routine and well-monitored treatment that provides immediate benefits.
3. Erythropoietin (EPO) Therapy
Some NICUs use EPO therapy to stimulate the baby’s bone marrow to produce more red blood cells, potentially reducing the need for transfusions. However, its use varies depending on hospital protocols and the baby’s specific medical condition.
How Parents Can Support Their Baby
Although anemia of prematurity is primarily managed by medical teams, parents can still play a role in their baby’s health and recovery:
Providing iron-rich nutrition – Breast milk and iron-fortified formula can help support blood production. If supplementation is needed after discharge, the care team will provide guidance.
Practicing skin-to-skin contact (kangaroo care) – Holding the baby close can help regulate their breathing, heart rate, and overall stability.
Asking questions about anemia management – Understanding the treatment plan and discussing any concerns with the NICU team can help parents feel more involved in their baby’s care.
A Temporary Challenge in the NICU Journey
Anemia of prematurity is a well-recognized and manageable condition that most preemies outgrow as their bodies mature. Regular monitoring, proper nutrition, and medical support ensure that babies receive the care they need to develop healthy red blood cell levels.
For parents navigating the NICU journey, understanding conditions like anemia of prematurity can provide reassurance and clarity. While it may be an unexpected hurdle, it is one that NICU teams are well-equipped to manage, helping babies grow stronger each day.
At NEOwell, we are here to support families through the challenges of preterm birth and NICU care. For more information on anemia of prematurity, contact NEOwell.