What You Need to Know About Iron Supplements for Kids
  /   Dr. John Snow

What You Need to Know About Iron Supplements for Kids

Growing children have a lot of needs for their social, mental, emotional, and physical health. 

As a parent, you’re constantly seeking effective ways to meet these needs. You want your child to grow and thrive, ultimately transforming into a happy, healthy, and successful adult. 

One of the most important things you do for your child is to provide proper nourishment. Your child’s body is in a constant state of growth and transformation. 

Throughout this period, their body needs vitamins, minerals, and nutrients to thrive. Iron is one of many minerals crucial to this process.

If your child’s pediatrician has expressed concern about your child’s iron intake, you probably have many questions. First, you want to clarify how much iron your child needs and what kind of supplement or dietary changes would be appropriate. 

Understanding the full scope of the situation will help you address your child’s needs adequately. 

Requirements for Iron in Childhood

Iron requirements begin at birth and continue throughout life. Iron requirements are just as important for newborns as they are for teenagers, although children within both age groups will have significantly different daily requirements. 

  • Newborn to 6 Months - 0.27 mg daily
  • Up to 12 Months - 11 mg daily
  • Up to 3 Years - 7 mg daily
  • Up to 8 Years -  10 mg daily
  • Up to 13 Years - 8 mg daily
  • 13 and Up - roughly 11 mg daily for boys, 15 mg daily for girls

Iron needs change with the developmental stage of a child’s life, waxing and waning until they increase around puberty. 

Special Considerations for Breastfed Babies

Breast milk is almost nutritionally perfect for babies. There are endless benefits to choosing to breastfeed, and that’s why so many mothers make that choice. 

One of the challenges mothers who breastfeed may face is that iron is exceptionally low in breast milk. If your infant’s pediatrician has concerns about your breastfed baby’s iron intake, you’ll likely be presented with two options. 

Incorporate essential vitamins into your baby’s diet according to their body weight. Work with your baby’s pediatrician to determine what the best option for your unique situation will be. 

Signs of Iron Deficiency in Children

Iron deficiency can manifest both physically and behaviorally. Children with iron deficiency may experience delays in psychological development. They may not progress as expected with their social skills, they could exhibit behavioral problems or demonstrate short attention spans.

Iron deficiency can also present in children as clammy or pale skin, reduced appetite, fatigue or sleepiness, and slower than average growth. Anemia is related to iron deficiency. Children who have anemia may require more iron.

In rare cases, iron deficiency may manifest as a condition called pica

For example, if your child attempts to eat sand, dirt, rocks, clay, or crayons. Pica alone is not enough to diagnose an iron deficiency. It may be symptomatic of other nutrient deficiencies, behavioral disorders, or neurological disorders. 

Iron Needs May Change in Puberty

Girls may need more iron during puberty due to their menstrual cycles. Girls with heavier periods may require more iron than other girls. 

While the average age for the onset of menstruation is around 12, it’s not unusual for girls to begin menstruating as early as age eight or as late as age 15. When menstruation starts, iron requirements for girls may fluctuate to levels outside of the chart of standard recommendations. 

If you believe your female child is having irregularly heavy periods and may require more iron. As a result, speak with your child’s pediatrician. 

The American College of Obstetricians and Gynecologists recommends that girls should have their first visit between the ages of 13 and 15. So it may be best to consult both your pediatrician and gynecologist.

Foods High in Iron

Ideally, children old enough to eat solid foods should be obtaining most of the vitamins and minerals they need through their diet. Unfortunately, allergies, food intolerances, picky eating, and plant-based diets may make it difficult for children to achieve their recommended daily values through meals.

Iron is abundant in red meat, poultry, and fish. It’s also found in beans, and to a lesser degree, leafy greens. If your child can consume standard servings of most meats at every meal, getting enough iron through diet alone may be an achievable goal. 

Prunes can be a valuable source of iron, but they often act as a natural laxative. 

This laxative effect is mild and gentle, but frequent consumption may intensify the effect. This means that prunes are often unsustainable as a long-term source of iron and may not be suitable for all children. On the other hand, fortified cereals, including baby cereals, will almost always contain iron. 

Just be sure to avoid fortified cereals that are high in sugar. 

The tradeoff of high amounts of added sugar for small amounts of iron may not be worthwhile. Current guidelines state that children should not exceed 25 grams of added sugar per day

Preventing Iron Deficiency

Iron deficiency is often preventable. Since vitamin C improves the body’s ability to utilize iron, adding more vitamin C into your child’s diet can help them make use of the iron they’re getting through their food intake. 

Sometimes, supplementing vitamin C may be enough to help your child achieve healthy iron levels. However, dairy products may also inhibit natural iron absorption. 

Children between the ages of one and five should not consume more than 24 ounces of milk a day. Milk can be healthy and beneficial to a growing child, but servings should be cautiously approached when parents have concerns about iron. 

When To Supplement Iron in Your Child’s Diet

Children should be screened for iron deficiency around their first birthday. At this time, your child’s pediatrician should be aware if your child has a deficiency. 

Deficiencies can develop at any time, and if parents or medical care providers have concerns, testing is required to determine iron deficiency.

Before providing your child with any supplement, you need to set up a consultation with your doctor. High levels of iron can become toxic and cause side effects such as:

  • Painful constipation
  • Liver damage
  • Irregularities with heart rhythm

Iron supplementation isn’t as simple of a choice as giving your child a multivitamin. To help make sure kids get enough iron, parents can:

  • Limit the amount of milk to 16-24 oz per day
  • Serve iron-fortified cereals
  • Serve iron-rich foods that contain vitamin C, such as broccoli, tomatoes, oranges, and strawberries

Your child’s pediatrician will explain the proper kind of iron supplement for your child, as well as the amount of iron it should contain and the frequency at which you should administer it. 

Follow your pediatrician’s recommendations and keep a close eye on potential side effects. 

Nausea, vomiting, and diarrhea are common side effects of high iron intake. However, rare side effects, like muscle weakness and a blue tinge to the skin -- especially under the fingernails -- are symptomatic of iron overdose, a condition that requires immediate intervention.

The Takeaway

Iron deficiency is a rare but serious problem that can negatively impact children in significant ways. Since iron requirements are much lower than the requirements for many other vitamins and minerals, many children are successfully able to meet their daily values through the foods they eat. 

Do not give your child an iron supplement unless your child’s pediatrician agrees that it’s necessary. While iron supplements make it easy to consume excessive iron, the overconsumption of iron may pose serious side effects that can harm your child’s health.

Even consumption of appropriate amounts of iron can cause mild side effects in some children, and if they do, you’ll need to work with your child’s pediatrician to reformulate your approach. 

Some children, like children on vegan or vegetarian diets and menstruating young women, will likely need iron supplementation more than other children. 

If you’ve identified your child as being at risk for iron deficiency, there’s a decent chance that your concerns are correct. Just be sure to speak to your pediatrician about your child’s concerns.


Pica (for Parents) |  KidsHealth

Prune juice has a mild laxative effect in adults with certain gastrointestinal symptoms | Science Direct

Sugar Recommendation Healthy Kids and Teens Infographic | American Heart Association