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This guidance refers to children and young people up to 16th birthday, or 18th birthday if the young person prefers to be seen in a paediatric setting.
Anaemia is very common in pre-school children, particularly between 6 and 24 months of age. Anaemia is usually nutritional in pre-school children and these can benefit from input from universal services (health visitors). Children of school age with anaemia require referral for assessment.
Anaemia should be suspected in a child who appears pale. Fatigue, myalgia and breathlessness are very rarely due to anaemia.
Haemoglobin less than age-appropriate normal range.
Children with suspected leukaemia or who are unwell are not covered by this guidance.
Antenatal risk factors
Diet history
Ethnic history
Family history
Symptoms
FBC and film – only – ferritin is not indicated in initial assessment
If microcytic anaemia – treat with oral iron and repeat FBC, plus IgA and coeliac screen after 2 weeks – ensure correct dose and compliance
If Hb increased by more than 10g/l continue iron for 3 months and no further investigation (it is not necessary to repeat FBC at end of this provided symptoms resolved)
If history suggestive of helminth infection – worms in stool, pica, pruritus ani, travel – it is reasonable to empirically treat with mebendazole
Pre-choice Triage is currently active for this specialty.
e-Referral Service Selection
NHS choices - Eat Well
This guideline has been signed off on behalf of NHS Devon.
Publication date: February 2017