Have you taken a look at GetDBCount? This will query the database using a filter and return the number of records that match. You can't use myEntity.RelatedEntity.Count since you would have to load the items, but you could do something like this.
DataAccessAdapter adapter = new DataAccessAdapter();
IRelationPredicateBucket filter = new RelationPredicateBucket();
filter.PredicateExpression.Add(OrderItemFields.OrderId == order.OrderId);
int amount = (int)adapter.GetDbCount(new OrderItemEntityFactory().CreateFields(), filter, null, false);
This would return a count for all items for the specified order.