The term “EPO baby” refers to an infant receiving prescribed doses of Erythropoietin, or EPO. This is a hormone that stimulates red blood cell production. While the name might be associated with sports doping, this is a legitimate medical therapy used to address specific health conditions in newborns, particularly premature babies. The use of EPO in infants is a targeted therapy designed to address anemia common in this population.
What is Erythropoietin (EPO)?
Erythropoietin is a hormone that directs the body to manufacture red blood cells. In adults and full-term infants, it is produced primarily by the kidneys. These organs sense the level of oxygen in the blood; if oxygen levels fall, the kidneys release EPO into the bloodstream. This hormone then travels to the bone marrow, which is the soft tissue inside bones responsible for creating new blood cells, and signals stem cells to develop into mature red blood cells.
The main function of red blood cells is to transport oxygen from the lungs to every tissue and organ. To address conditions where the body does not produce enough EPO on its own, scientists developed a synthetic version called recombinant human erythropoietin (rhEPO). This laboratory-made version is biologically identical to the natural hormone and is used as a medication to stimulate red blood cell production.
Medical Use of EPO in Infants
The phrase “EPO baby” is applied to a premature infant undergoing treatment for a condition called anemia of prematurity. This form of anemia is common in babies born too early and is characterized by a low red blood cell count. Several factors contribute to this condition, as their bodies are not yet fully developed to produce sufficient amounts of the hormone.
Premature infants also have a very small total blood volume. They often require frequent blood draws for necessary medical tests and monitoring in the neonatal intensive care unit (NICU). These blood draws can represent a significant portion of their total blood supply, further depleting their red blood cell count. This combination of low natural EPO production and blood loss creates a state of anemia.
When a premature infant develops anemia, one treatment option is a blood transfusion. An alternative approach is to administer rhEPO, which encourages the infant’s own bone marrow to produce new red blood cells. A primary benefit of this treatment is the potential to reduce the number of blood transfusions an infant needs, thereby avoiding potential risks associated with them. The treatment is considered for very low birth weight infants, often those weighing less than 1,250 grams.
The EPO Treatment Process and Safety
When EPO is used to treat anemia of prematurity, it is administered as a carefully dosed medication under strict medical supervision. The treatment involves a series of injections given over several weeks. A common regimen involves administering rhEPO subcutaneously, meaning just under the skin, three times a week. The dosage is calculated based on the infant’s weight, and the therapy can last for four to six weeks.
Alongside EPO, infants are also given iron supplements, as iron is a building block for producing red blood cells. Medical staff closely monitor the infant’s progress throughout the treatment. They regularly check the hematocrit, which measures the proportion of red blood cells in the blood, and the reticulocyte count, which indicates the rate of new red blood cell production.
The use of rhEPO in premature infants has been studied for decades and is considered a safe therapy. Concerns about certain side effects, such as a condition affecting the eyes called retinopathy of prematurity, have been investigated. A recent systematic review refuted previous concerns that early administration of EPO was associated with increased retinopathy of prematurity. The treatment is well-tolerated and supports development by ensuring the body is well-oxygenated.
Distinguishing Medical Use from Athletic Doping
The medical application of EPO must be differentiated from its illicit use as a performance-enhancing drug in sports. In a medical context, EPO is prescribed to correct a physiological deficiency. The infant is unable to produce enough red blood cells on their own, and the treatment helps restore their levels to a normal, healthy range to treat diagnosed anemia.
In athletic doping, the motivation is entirely different. Athletes who misuse EPO are not deficient in red blood cells; they use the substance to artificially boost their red blood cell count far beyond normal levels. This increase allows their blood to carry more oxygen, which can enhance endurance and athletic performance. This represents an attempt to gain an unfair competitive advantage.
The context of administration also differs greatly. For an “EPO baby,” the hormone is given in a controlled clinical setting, with doses prescribed by a physician and the infant’s health closely monitored. In contrast, athletes using EPO for doping do so without medical supervision, often using excessive doses that can pose significant health risks, including an increased chance of blood clots, stroke, and heart attack.