Nutritional Anaemia in Children

This narrative review looks at the three main nutritional reasons children become anaemic: iron deficiency, anaemia that develops alongside protein-energy malnutrition, and deficiency of folate or vitamin B12. It is written as a practical reference for medical students, general paediatricians and primary-care doctors. Low haemoglobin is a warning sign, not a diagnosis, and in children several causes often overlap. The article explains how each deficiency develops, what it looks like at the bedside, and which laboratory findings point to it. It also shows how to tell iron deficiency apart from other causes of small red cells, such as thalassaemia trait and anaemia of inflammation, and how to separate folate deficiency from B12 deficiency. Particular attention is given to B12, because a shortage in infancy can harm the developing nervous system even without anaemia. The review draws on recent guidance from the World Health Organization, the American Academy of Pediatrics, the Indian Academy of Pediatrics and the NIH Office of Dietary Supplements, along with supporting published studies. It covers global prevalence trends, age-specific haemoglobin thresholds, interpretation of ferritin, treatment and follow-up, and prevention through infant feeding, supplementation and screening. It ends with a step-by-step diagnostic approach for a child with suspected nutritional anaemia. The paper includes six tables, two original figures and a reference list. It is a narrative synthesis of existing guidelines, not a systematic review, and it contains no new patient data. Doses mentioned are for educational reference and should be checked against current local guidelines before clinical use.