Iron Deficiency in Children: Causes, Symptoms, and Solutions
  /   Dr. John Snow

Iron Deficiency in Children: Causes, Symptoms, and Solutions

Vitamin and mineral deficiencies in children can have long-lasting consequences. 

Everyone needs to meet their daily recommended value of every vitamin and mineral, but it’s especially important for growing and developing bodies. If you’re worried your child may not be getting enough iron, here’s what you should know.

How Common Is Iron Deficiency In Young Children?

Iron deficiency is somewhat common in children, partially because there are so many risk factors for a deficiency, and good sources of iron are limited. 

You should keep a watchful eye on your child’s iron intake if they fall into any of the following categories:

  • Premature babies
  • Babies with below average birth weight
  • Babies who are given plant milk or cow’s milk instead of breastmilk or formula
  • Babies or kids who drink more than 24 ounces of milk per day. Too much milk can interfere with iron absorption
  • Formula-fed babies who aren’t fed a formula fortified with iron
  • Picky eaters and children with dietary restrictions
  • Overweight kids and teens
  • Menstruating girls (blood loss causes iron loss)

What Are the Symptoms of Iron Deficiency in Children?

Iron deficiency can lead to iron deficiency anemia, a condition where the body can’t make enough healthy red blood cells to circulate hemoglobin (oxygen in the blood) throughout the body. 

If your child isn’t getting the right amount of iron to carry oxygen in their blood, you might notice symptoms such as:

  • Fatigue
  • Difficulty concentrating
  • Shortness of breath
  • Pale skin
  • Eating things or craving things that aren’t food
  • Shallow or fast breathing
  • Low mood
  • Behavioral issues or inability to pay attention
  • Delayed growth
  • Delayed development

Some of these symptoms may be difficult to catch — plenty of curious kids will attempt to eat a handful of sand from their sandbox or some sidewalk chalk. It’s a little experiment that won’t work out in your child’s favor when they realize it doesn’t taste as good as it seems. 

It only becomes a symptom of a larger problem if your child attempts to make a habit of eating non-nutritive things. This behavior is called pica. Pica doesn’t always correlate to a nutrient deficiency, but deficiencies are on the short list of concerns when children try to eat things like dirt, sand, clay, or chalk. 

These substances are naturally full of minerals, and the way they smell could be sending a subconscious signal to your child’s brain that they need to eat it.

Symptoms like behavioral issues, difficulty concentrating, or an inability to pay attention can also be tricky to spot. Sometimes kids get distracted. They may occasionally get rowdy. It doesn’t always mean that there’s an underlying problem. It could just be that your child is bored or excited.

It becomes a cause for concern when these behaviors and difficulties are consistent, especially if your child seems to actively be attempting to avoid them. Many factors can cause long-term issues with concentration or behavior management, and nutrient deficiencies are merely one potential culprit. 

How Much Iron Does My Child Need?

It can be difficult to keep track of how much iron your child needs because iron needs fluctuate with age and phases of development. Your children will need an increasing amount of certain minerals as they age, but iron is a little bit different within each age bracket. 

In general, the following amounts of iron are enough to maintain proper iron levels:

  • Babies 7 to 12 months of age: 11 mg daily
  • Children 1 to 3 years of age: 7 mg daily
  • Children 4 to 8 years of age: 10 mg daily
  • Children 9 to 13 years of age: 8 mg daily
  • Menstruating teens: 15 mg daily
  • Non-menstruating teens: 11 mg daily

Menstruation can increase the need for iron in teens because periods are the leading cause of iron loss. In some cases, heavy periods can even lead to iron deficiency anemia and other complications. Your teen’s need for iron can increase at any time, usually between the ages of 10 and 15 years old. It’s typically important to increase iron intake as soon as your teen’s period starts.

Can My Child Have Too Much Iron?

Most children’s multivitamins don’t contain iron to help parents prevent accidental over-ingestion of iron. Many foods that children eat are fortified with iron, so most healthy children won’t need supplemental iron. 

It’s possible to ingest too much iron, which may cause side effects. Over-ingestion of iron can cause joint pain, abdominal pain, and in very rare cases, heart failure. A surplus of iron is most likely to cause uncomfortable constipation. This can usually be resolved with gentle at-home remedies and a change of diet. 

What Foods Contain Iron?

The best way to help your child meet their recommended daily values of vitamins and minerals is through their diet. In a perfect world, that would always be possible. Food allergies, dietary restrictions, and picky eating habits can make it tricky to serve enough iron-rich foods throughout the day. Here are a few foods you can try to incorporate into your family’s diet.

Foods With Naturally Occurring Iron

Some foods naturally contain iron, making them great options to include in your child’s diet. Examples include:

  • Red meat, like liver and beef
  • Shellfish like mussels and oysters
  • Sardines
  • Chicken
  • Salmon
  • Tuna
  • Tofu
  • Lima beans
  • Kidney beans
  • Chickpeas
  • Nuts

Leafy greens also contain iron, but the amount per serving is very low. It would be difficult to meet your daily iron needs through greens alone.

It can be very difficult to incorporate a sufficient amount of foods with naturally occurring iron into your family’s diet. Shellfish, fish, and nuts are common allergens. Plenty of adults couldn’t be bribed to eat liver, let alone kids. 

Since a lot of these foods are animal-based, many of them are off the menu in plant-based households. Combining plant-based sources of iron with iron-fortified foods can round out a plant-based diet.

Iron-Fortified Foods

On the other side of things, some foods do not contain substantial iron naturally, and instead are fortified with added iron during the production process. 

Iron-fortified foods include:

  • Enriched pasta
  • Enriched rice
  • Fortified cereal
  • Fortified bread

You need to specifically select a product labeled as fortified or enriched because most pasta, bread, and rice products aren’t enriched by default. 

Orange juice can help to increase the absorption of iron from fortified foods, which makes breakfast a great time to serve up most of the iron your family needs for the day.

Check the ingredients before you buy these foods to make sure you’re getting the kind you want. Be on the lookout for things like added sugars, artificial sweeteners, and other ingredients you’d prefer to avoid serving your family.

How To Encourage Your Picky Eater To Enjoy Iron-Rich Foods

You won’t have much of a problem encouraging your picky eater to enjoy iron-rich foods if you make a simple swap. Your child won’t know that their macaroni and cheese is made with enriched pasta because it won’t taste any different. They also won’t know that you’ve swapped in fortified bread for their almond butter and jelly sandwich. 

If your family regularly eats things like meat and beans, serve them up to your child the same way you’d serve them up to everyone else. When children see adults they trust enjoying something, they’re always a little curious about what the big deal is. Think about how they ask for a sip of your coffee and apply the same concept to foods they don’t ordinarily eat. 

Have everyone at the table make a big deal about how delicious they are and how much they love them. Casually mention how these foods help you grow up and get strong. Don’t tell your child that they have to eat them or apply pressure to the situation.

Most children will cave to the influence of their parent modeling positive behavior and a little bit of innocent peer pressure. When they see how much fun you’re having and how much you love something, they’re more likely to want to try it. 

Do Iron Supplements Work For Kids?

Supplements are an option, but you should always attempt to meet your needs through the things you put on your plate. Iron supplements are a valuable solution for people who are having trouble getting enough iron through their diet. 

Does My Child Need Iron Supplements?

Incorporating a low-sugar, iron-fortified cereal into your child’s diet and using iron-fortified bread, rice, and pasta should be more than enough to help your child meet their requirements. Making sure your child consumes plenty of vitamin C is also important, as vitamin C supports the proper absorption of iron.

If you believe it isn’t or if your child can’t eat these things, it’s best to speak to your child’s pediatrician about low iron. A lack of iron can become very serious, and your child may need special supplements if they’re deficient in iron. Your pediatrician can run blood tests, like a complete blood count, to help diagnose an iron deficiency.

The Wrap-Up: Iron is Important for Your Kids

Iron is just as important as any other vitamin and mineral, and iron deficiency is an issue that needs to be taken seriously. Changing your child’s diet can go a long way in helping them meet their daily recommended amount of iron and stave off deficiency. If your child has food restrictions or is a picky eater, supplements can help.


Iron Deficiency in Menstruating Adult Women: Much More than Anemia | Women's Health Reports | Mary Ann Liebert Publishing

Iron | Nutrition | CDC

Pica (for Parents) | Nemours KidsHealth