You probably don't consciously evaluate your child's color each day, but your parental radar might alert you to the fact that your child looks paler than usual. Paleness could be a normal seasonal change, but it can also be caused by changes in the number of red blood cells in the body or the amount of blood flowing to the skin. Talk to your child's doctor if your child seems to be unusually pale.
Sometimes, Nothing's Wrong
Some children are naturally fair-skinned, and this can become more obvious in the wintertime. The lack of sun exposure during the winter months is a common cause of pale skin. To determine whether this may be the cause, you can check the skin on the palms of your child's hands. Because the palms are not affected by sun exposure, the color here is a good indicator of whether the paleness is simply due to a seasonal change in skin color.
A decreased number of red blood cells in the body -- known as anemia -- can cause your child to appear pale. Anemia is most commonly due to an inadequate amount of iron in the diet. Without sufficient iron, the body cannot produce a normal number of red blood cells. Premature infants, who don't have time to build up their iron stores before birth, are particularly likely to develop anemia by the time they are 6 months old. According to a report from the American Academy of Pediatrics published in October 2010, iron-deficiency anemia affects approximately 1 to 4.5 percent of toddlers 1 to 3 years of age in the United States. Simple blood tests can diagnose iron-deficiency anemia.
Less Common Causes of Anemia
Anemia has many other causes. Some of these, like iron-deficiency anemia, are due to decreased production of red blood cells. Ingestion of toxins, such as lead, is an example of this. Reduced production of red blood cells can also occur with many medical conditions, such as severe infections, kidney or liver disease, or leukemia. In other conditions, such as sickle cell anemia or thalassemia, anemia is caused by excessive destruction of red blood cells within the body. Severe bleeding can also cause anemia. Although they are not common, most of these other causes of anemia are serious, so it is important to talk to your child's doctor if your child seems pale.
Other Causes of Pale Skin
Your child can also appear pale if less blood is flowing to his or her skin. Dehydration due to vomiting or diarrhea is a common cause of reduced blood flow and pale skin. Low blood pressure from any severe illness will also reduce the amount of blood flowing to the skin. If your child is pale and appears generally ill, feels faint or lightheaded, or may be suffering from dehydration, contact your child's doctor.
- Tropical Medicine and International Health: Evaluation of Clinical Pallor in the Identification and Treatment of Children with Moderate and Severe Anaemia
- Manual for the Health Care of Children in Humanitarian Emergencies; World Health Organization; 2008
- Textbook of Pediatric Emergency Medicine (Textbook of Pediatric Medicine); Gary Fleischer, Stephen Ludwig; 2010
- Pediatric Complaints and Diagnostic Dilemmas: A Case-Based Approach; Stephen Ludwig; 2004
- Pediatrics: Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0–3 Years of Age)