Neonatal Anaemia

Neonatal anaemia may result from blood loss, haemolysis or inadequate erythropoiesis. Premature infants commonly develop anaemia of prematurity due to reduced erythropoietin response, rapid growth and repeated phlebotomy.

• Pallor
• Tachycardia
• Poor feeding
• Tachypnoea
• Increasing oxygen requirement
• Poor weight gain
• Apnoea in preterm infants

Assess:

• Haemoglobin and haematocrit
• Reticulocyte count
• Blood film
• Bilirubin
• Direct antiglobulin test when haemolysis is suspected

Interpret haemoglobin according to gestational and postnatal age.

Treat the cause.

Minimize unnecessary blood sampling in premature infants.

Packed red cell transfusion is based on haemoglobin, respiratory support and clinical symptoms rather than a single universal threshold.

A typical neonatal packed cell transfusion volume is approximately 10 to 15 mL/kg, given slowly with monitoring.