Iron Deficiency (Anemia) in Children

Iron Deficiency (Anemia) in Children

According to one World Health Organization (WHO) report, toddlers and kids of preschool age have the highest prevalence of anemia at 47.4% of their population group. This is mostly because of their food choices. This data is undoubtedly appalling for any parent, so it’s always crucial to make sure the child has a balanced diet to fulfil the intake of this important mineral.

Did you know that iron deficiency anemia, particularly in developing countries, is almost forming a shape of a global epidemic? Iron deficiency during pregnancy is one of the leading causes of anemia in infants and young children. The World Health Organization has stated that 30% of the global population is affected by this widespread nutrient deficiency. 

Anemia is usually defined according to the body’s hemoglobin levels, which are dependent on many factors most importantly age, gender, and ethnicity. Iron treatment should be started once iron deficiency anemia is recognized in infants and young children.

Importance of Iron in Children

Iron is an important part of hemoglobin, a certain pigmented protein in red blood cells that is in charge of carrying oxygen from the lungs to the rest of the body. In case there’s a dearth of iron in the body, the child may grow learning or behavioral issues since iron is key for energy, muscle function, and brain development.

Kids need a steady amount of iron to fuel their rapid growth & development. Iron deficiency leads to anemia and is often associated with impaired neurocognitive development in kids, including slower visual & auditory processing. Full-term healthy babies derive enough iron from mothers in the third trimester of pregnancy which tends to last for the first 4 months of life.

Iron deficiency can in fact affect how kids perform in school. Not having enough iron may  lead to trouble concentrating, a shorter attention span, and eventually not-so-good grades in class. If your kid is experiencing fatigue, lethargy, & weakness, which are the most common symptoms of low iron, remember he/she is not alone. In fact, iron deficiency is one of the most common deficiencies in the world. It can hugely impact immune function and predispose kids to recurrent infections.

How Much Iron Do Children Need?

Wondering how much of this essential nutrient your child needs daily?

Here go the recommendations to make your life easier:

  • 7-12 months: 11 mg/ day
  • 1-3 years: 7mg/day
  • 4-8 years: 10mg/day
  • 9-13 years: 8 mg/day

What Causes Iron Deficiency Anemia?

The main risk factors in babies are:

  • Maternal iron deficiency
  • Premature birth & or low birth weight
  • Twin pregnancy
  • Delayed introduction of solids
  • Inappropriate weaning onto solids eg low iron-rich foods

Risk factors in children & toddlers are:

  • Excessive consumption of cow milk
  • Fussy or extreme picky eaters who have a limited dietary intake
  • Vegetarian or vegan diets

Signs & Symptoms of Iron Deficiency Anemia

Symptoms of iron deficiency may include:

  • Being pale or having yellow sallow skin
  • Unexplained fatigue or lack of energy
  • Shortness of breath or chest pain especially with activity
  • Unexplained weakness in general
  • Heart palpitations
  • Headache, especially with activity
  • Brittle nails or hair loss
  • Cold feet & hands
  • An unrelenting desire to eat/chew strange things (e.g ice, dirt, clay)
  • Trouble sleeping
  • Susceptibility to infections

If you notice any of these in your kids, always make it a point to consult with your Pediatric dietician or other healthcare practitioners to discuss their iron intake & status.

The assessment involves going over a detailed history, nutritional intake, a physical examination, and finally, a lab test that involves a complete blood count, including hemoglobin level, assessment of iron status, and body stores that involve special tests.

Treatment for Iron Deficiency Anemia

Here are some of the ways you can consider to prevent iron deficiency:

  • A daily iron supplement can be given to breastfed-only infants(starting from 4 months of age) until they begin consuming iron-rich food items. Formula-fed infants do not require iron supplements as the formula has already iron added to it.
  • As and when babies start consuming solids, make sure to add loads of iron-rich foods to the diet. 
  • Make it a point not to overdo milk between ages 1 and 5. Don’t make them drink more than 24 ounces (710 milliliters) of milk a day.
  • Vitamin C enhances the absorption of dietary iron. So, including a glass of orange juice or serving them Vitamin C rich fruits such as strawberries, kiwi & melons is a good idea.

Preventing Iron Deficiency Anemia in Children

Some thumb rules here:

  • Babies below 12 months should be breastfed or have an iron-fortified infant formula
  • First foods should always be iron-rich. Breastmilk or formula milk will provide the required iron to the baby for the first 6 months. Post 6 months when you’re introducing solids focus on the iron-loaded foods to begin.
  • Add a variety of iron-rich foods to your kid’s diet. 
Animal Sources: 
  • Eggs
  • Red Meat
  • Chicken
  • Fish 
Plant-based Sources: 
  • Spinach
  • Broccoli
  • Green peas
  • Pulses
  • Legumes
  • Beans
  • Lentils & tofu
  • Nut/seed pastes(or whole nuts for older children) 
  • Avoid serving milk at main meals as this can affect the child’s appetite and as a result, they will be less hungry to consume the iron-rich foods. Besides, milk also lowers the absorption of iron in our bodies. 
  • Try pairing iron-rich foods with foods high in vitamin C as it can help your kid absorb the iron better. 

Here go some ideas for pairing vitamin C and iron foods for toddlers:

  • Wholegrain cereal with berries
  • Stir-fry with choice of meat & mixed vegetables like spinach, capsicum, cabbage, broccoli
  • Capsicum sticks with hummus dip. 

Some kitchen staples to ward off iron deficiency include: 

  • Serve iron-rich foods such as iron-fortified baby cereal, and pureed meats/beans. For older kids, you can add red meat, chicken, fish, beans & spinach to their diet.
  • Vitamin C helps promote the absorption of dietary iron. So serving your kid foods rich in vitamin C (such as citrus fruits, cantaloupe, strawberries, bell peppers, kiwis, or tomatoes) is a must! 

Iron in food comes in 2 forms: haem & non-haem iron.

Haem Iron: Present in meats & more easily absorbed by the human body.

Non-Haem Iron: Plant sources such as legumes, vegetables, & cereals, etc. 

  • It’s time to ditch the non-stick & aluminum vessels and invest in a heavy bottom 100% cast iron pan for your kitchen. Although both cost almost the same, the latter is far superior because of the nutritional value they add to the food cooked in it.  

Looking for an iron supplement that’s both effective & delicious?

Your search ends here! Try Advanced Iron Gummies & see the difference yourself.

These gummies are not only a fun & easy way for children to get their daily dose of iron but they also help prevent iron deficiency and associated fatigue. Formulated by our team of doctors, these treats will help support your child’s nutritional levels during times of growth spurts and occasional times of fussy eating & low appetite. 

Never procrastinate seeing the doctor in case you suspect that your child’s iron store is low. In case they’ve been prescribed iron supplements by the doctor consider continuing them in addition to iron-rich meals and snacks. 

  • In a lot of cases, iron supplements may cause stomach cramps, constipation, nausea, and vomiting initially as the body takes its own time to adjust to the medication. Sometimes, iron can turn the stools to turn black in colour. This happens because of unabsorbed iron and is usually something not to worry about. 
  • However, we would only advise you to always be on guard as iron gets toxic in higher dosages. Notify your doctor immediately in case your child develops severe stomach pains, chest pain, bluish lips, or fingernails.
  • No matter how convenient they may sound, self-diagnosis and feeding your child over-the-counter iron supplements are a strict no-no. Here’s why. Most iron supplements contain about 100mg per tablet whereas, for young kids, 20mg per day is considered the safe upper limit. 

*** Author Name: Deepashree Banerjee (7+ years of diverse experience in content creation & journalism.)