Did you know that iron-deficiency anemia affects an estimated 269 million children worldwide? And that kids between the ages of two and five and teenage girls in puberty are the two pediatric age groups with the highest risk for developing iron deficiency anemia.
Iron is like a superhero nutrient for our children’s health and development, yet iron deficiency in kids is surprisingly common. Let’s dive into everything you need to know about low iron, symptoms to look out for, and what treatment to expect.
What Is Iron-Deficiency Anemia In Children?
Iron deficiency anemia is the most common type of anemia, which is a condition where the blood doesn’t produce enough healthy red blood cells. When there’s too little iron in the body, it struggles to make hemoglobin, a protein responsible for transporting oxygen.
Because iron deficiency affects red blood cell production, it can lead to:
- Lower red blood cell count: The body struggles to transport enough oxygen.
- Reduced capacity to carry oxygen: Organs and tissues receive less oxygen.
There are different stages of iron deficiency:
- Mild deficiency: A drop in iron levels in the bone marrow and serum ferritin concentrations. Ferritin is a protein in cells that stores iron, so the level of ferritin in the blood reflects iron stores in the body.
- Marginal deficiency: At this point, iron stores are depleted, but hemoglobin levels usually stick within the normal range.
- Iron deficiency anemia: Iron stores are entirely exhausted.
What Causes Iron-Deficiency Anemia In A Child?
There are several causes of iron deficiency anemia in kids; let’s dive into the most common causes of low iron levels.
Low Iron Diets
A low-iron diet is one of the most common causes of child iron deficiency. A low iron diet in kids can occur for a few reasons:
- Picky eating: Iron-rich foods include lean meats, beans, and dark leafy greens. Fussy eaters are at a higher risk of not getting enough iron.
- Vegetarian or vegan diets: Some of the richest sources of iron are animal-based, so those following veggie or vegan diets may be at a higher risk of eating fewer iron-rich foods.
- Cow’s milk: Cow’s milk can impact iron absorption.
Globally, up to 50% of cases of iron deficiency in the developed world result from insufficient iron intake.
Low iron levels in a newborn baby increase the risk of iron deficiency anemia. In most cases, newborns have enough iron stored in their bodies for approximately six months. After this, babies need an external source of iron apart from breast milk. The CDC recommends that at about six months old, you can start introducing iron-rich foods to support healthy development.
Changing Bodies
When children go through stages of rapid growth, they have a much higher demand for iron for several reasons:
- Red blood cell production: Children experiencing rapid growth need more red blood cells to get oxygen to developing organs and tissue.
- Brain development: Iron plays a vital role in cognitive development, including learning, memory, and attention span.
- Energy production: Adequate iron levels help children maintain energy levels necessary for physical activity, growth, and overall well-being.
- Development: Iron plays a role in synthesizing DNA, RNA, and proteins, crucial for cell growth, repair, and development.
Gastrointestinal (GI) tract problems
GI tract problems, like Crohn’s disease, may contribute to iron deficiency because of the way they impact iron absorption. Conditions that can affect iron absorption include celiac disease, Crohn's disease, and ulcerative colitis.
Blood loss
Blood loss can decrease iron stores, depending on the cause. Because iron is mostly stored in hemoglobin in the blood, when blood is lost (either chronically or acutely), it can lead to a decrease in red blood cells and a loss of iron.
Sources of blood loss include:
- Menstrual bleeding
- Gastrointestinal disorders
- Injury
- Chronic conditions
- Surgery
What Are The Symptoms Of Iron-Deficiency Anemia In A Child?
The severity and symptoms that children experience from iron-deficiency anemia can vary. Your child may not exhibit every symptom, but these are signs of iron deficiency in kids to be aware of:
- Pale skin, lips, and nail beds
- Tiredness and decreased energy
- Poor mood and irritability
- Shortness of breath
- Cold hands and feet
- Restless sleep
- Headaches and dizziness
- Frequent infections
- Slowed growth and development
- Cravings for unusual substances (also called pica)
Sometimes, iron deficiency symptoms may not be obvious, but they look pale or tired. The above symptoms can overlap with other conditions and may have other causes, which is where blood tests can help you rule out any underlying health issues.
In severe cases, chronic iron deficiency anemia in infants may result in long-lasting cognitive and motor development delays. Prompt diagnosis and treatments are crucial for helping children with iron deficiency avoid long-term consequences and get back to full health.
How Is Iron-Deficiency Anemia Diagnosed In A Child?
The American Academy of Pediatrics (AAP) recommends screening for anemia at nine to twelve months old, with those at higher risk also being tested again at a later age.
Diagnosing iron-deficiency anemia in kids typically involves laboratory tests alongside a history and physical examination. So, your doctor may ask you about your child’s symptoms, diet, and medical history. Your healthcare provider may also assess your child’s health and look for abnormalities, checking for paleness or brittle nails.
In most cases, blood tests for anemia in children test the following:
- Complete blood count (CBC): This test is essential and measures various blood cell types, including red blood cells (RBCs), their size and shape, and hemoglobin levels.
- Serum ferritin: This test measures the body's iron stores. In iron deficiency anemia, serum ferritin levels will be low.
- Hemoglobin and hematocrit: Both are important indicators of anemia and are often the first screening test for anemia, providing valuable information about red blood cell count and oxygen-carrying capacity.
Doctors also consider factors associated with a higher risk for iron deficiency anemia, like age, developmental stage, gender, and diet.
How Is Iron-Deficiency Anemia Treated In A Child?
Iron deficiency anemia treatment in children aims to replenish depleted iron stores, address any underlying causes, and improve overall symptoms and health.
The best treatment option will depend on the child and symptoms. If an underlying cause or specific condition contributes to iron deficiency, treating that condition will be essential. Typically, treatment will involve dietary changes and iron supplements, as recommended by your doctor. Please seek advice from your healthcare provider to determine the suitable recommended dosage for your child.
Foods high in iron for kids include:
- Dark leafy greens
- Lean meats
- Chickpeas
- Lentils
It’s also a good idea to include sources of vitamin C to enhance iron absorption and limit cow’s milk intake, as calcium can impact iron absorption when consumed close to iron intake.
Treatment for iron deficiency anemia can also include iron supplements, which can come in forms such as drops, tablets, and chewables. Before starting your child on iron supplements, it's always important to consult your pediatrician to determine need and the best dosage based on your child's age, weight, and medical history.
Factors like picky eating, limited dietary iron intake, and iron demands are all important when considering iron for kids. Choosing a quality, third-party-tested iron supplement developed specifically for kids is important.
What Can I Do To Prevent Iron-Deficiency Anemia In My Child?
The good news is that iron deficiency anemia is preventable. Eating a well-balanced diet with plenty of sources of iron can help prevent iron deficiency anemia. Sometimes, kids need more iron than their diet provides. If this is the case, your doctor may recommend an iron supplement.
The best iron supplement for kids is exactly that: designed for kids. Only consider supplements with an age-appropriate dosage and use a formula created with children at the forefront, under the guidance of your doctor.
Additionally, it's incredibly important to monitor children taking iron supplements at all times and store iron-containing products out of reach of children to prevent accidental ingestion. Iron overdose can be extremely dangerous and may lead to serious health complications.
Here are some general guidelines for preventing iron deficiency in children:
- Full-term infants: At about four months, your doctor may recommend a daily iron supplement for breastfed or partly breastfed babies until they start eating sources of iron.
- Premature infants: Your doctor may recommend giving your baby an iron supplement from two weeks until one year of age.
- Screening: Attend routine screening for iron deficiency anemia.
- Cow’s milk: Be mindful of how much cow’s milk your child drinks so it doesn’t impact iron absorption.
- Iron-rich foods: Include plenty of iron-rich foods in your child’s diet.
The exact recommendations for babies and infants will depend on your child and your doctor’s advice. A healthy diet with iron-rich sources, routine screening appointments, speaking to your child’s doctor, and adding kids vitamins with iron when necessary are all helpful in preventing iron deficiency.
When Should I Call My Child's Healthcare Provider?
If you have concerns about your child at all, speak to your healthcare provider. If you notice any signs that suggest iron deficiency anemia, like fatigue or pale skin, contact your doctor. Early diagnosis and treatment help improve outcomes.
Helping Your Kids Maintain Healthy Iron Levels
Helping your child stay healthy involves keeping their iron levels in check. By offering iron-rich foods, staying mindful of their diet, and watching for any signs of low iron, you're helping them thrive every step of the way. If needed, add a quality iron supplement such as Kids Daily Iron+. As with any medical changes, always speak with your pediatrician to establish the safest dosage tailored to your child’s individual needs.
Disclaimer: This is not medical advice. Please always consult with your pediatrician before giving your child iron and confirm which dosage is best for your child.
Warning: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Keep all iron products out of reach of children. In case of accidental overdose, call a doctor or poison control center immediately.
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