Anemia of Prematurity


Anemia is a low level of red blood cells (RBCs). These cells pick up oxygen in the lungs and bring it to the rest of the body. Low levels make it hard for the body to get enough oxygen.

Anemia of prematurity is when this problem happens in babies who are born too early.


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Anemia of prematurity may be caused by 1 or more of the these problems:

  • Loss of blood due to:
    • Problems during labor and birth
    • Removal of blood for testing—regular blood tests are needed to monitor the health of babies born too early
  • Low production of RBCs due to:
    • Nutrition problems
    • Infections such as rubella or parvovirus that affect the bone marrow where RBCs are made
  • Destruction of RBCs from health problems like:
    • Incompatibility between mother’s and baby’s blood—Rh incompatibility
    • Hereditary disorders

Risk Factors

Infants are likely to get anemia because:

  • Fewer RBCs are made in newborns right after birth
  • Blood volume cannot keep up with a baby’s growth
  • RBCs have a shorter lifespan in infants

Things that may raise the risk of this problem are:

  • Family history of anemia
  • Problems during delivery
  • Blood loss during birth
  • An illness that requires a lot of blood work
  • Being a twin with twin-to-twin transfusion
  • Poor diet that is low in iron, vitamin B6, or B12 in:
    • Mother during pregnancy
    • Infant after birth


Mild anemia may have no symptoms. Moderate or severe anemia may cause:

  • Pale skin
  • Low activity level
  • Fast or difficult breathing
  • Problems feeding
  • Fast heart rate
  • Slow weight gain
  • Periods when breathing stops


You will be asked about your baby’s symptoms and health history. A physical exam will be done.

Your baby's blood will be tested. This can be done with blood tests.

A diagnosis will be made based on the blood test. The test results may also help find the cause of the anemia.


Treatment will depend on the cause of anemia. Mild anemia may be monitored with blood tests. As little blood as possible will be taken to keep the anemia from getting worse.

Treatment options are:

Better Nutrition

Nutrition can help with recovery by helping the body make more RBCs.

Iron is important in making RBCs. Some babies may be given supplemental iron.

Blood Transfusion

Some babies with severe problems may need treatment right away. A blood transfusion can quickly raise the level of RBCs. It may need to be done more than 1 time.


To lower a child’s chance of getting anemia of prematurity:

  • Get proper prenatal care throughout pregnancy.
  • Mothers should take steps to prevent premature birth:
    • Avoid alcohol, smoking, and drugs.
    • Eat a healthy, balanced diet with plenty of fruits and vegetables.
    • Manage chronic health problems.
  • Provide proper nutrition to babies.


Healthy Children—American Academy of Pediatrics
Kids Health—Nemours Foundation


The Society of Obstetricians and Gynaecologists of Canada


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Last reviewed September 2019 by EBSCO Medical Review Board Kari Kassir, MD
Last Updated: 6/3/2020

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