Iron deficiency in children: Prevention tips for parents
Iron deficiency in children can affect development and lead to anemia. Find out how much iron your child needs, the best sources of iron and more.
Iron is a nutrient that’s essential to your child’s growth and development, but some kids don’t have enough. Find out what causes iron deficiency in children, how to recognize it and how to prevent it.
Why is iron important for children?
Iron helps move oxygen from the lungs to the rest of the body and helps muscles store and use oxygen. If your child’s diet lacks iron, he or she might develop a condition called iron deficiency.
Iron deficiency in children is a common problem. It can occur at many levels, from a mild deficiency all the way to iron deficiency anemia — a condition in which blood doesn’t have enough healthy red blood cells. Untreated iron deficiency can affect a child’s growth and development.
How much iron do children need?
Babies are born with iron stored in their bodies, but a steady amount of additional iron is needed to fuel a child’s rapid growth and development. Here’s a guide to iron needs at different ages:
Age group | Recommended amount of iron a day |
7 – 12 months | 11 mg |
1 – 3 years | 7 mg |
4 – 8 years | 10 mg |
9 – 13 years | 8 mg |
14 – 18 years, girls | 15 mg |
14 – 18 years, boys | 11 mg |
Who's at risk of iron deficiency?
Infants and children at highest risk of iron deficiency include:
- Babies who are born prematurely or have a low birth weight
- Babies who drink cow’s milk or goat’s milk before age 1
- Breast-fed babies who aren’t given complementary foods containing iron after age 6 months
- Babies who drink formula that isn’t fortified with iron
- Children ages 1 to 5 who drink more than 24 ounces (710 milliliters) of cow’s milk, goat’s milk or soy milk a day
- Children who have certain health conditions, such as chronic infections or restricted diets
- Children who have been exposed to lead
- Children who don’t eat enough iron-rich foods
- Children who are overweight or obese
Adolescent girls also are at higher risk of iron deficiency because their bodies lose iron during menstruation.
What are the signs and symptoms of iron deficiency in children?
Too little iron can impair your child’s ability to function well. However, most signs and symptoms of iron deficiency in children don’t appear until iron deficiency anemia occurs. If your child has risk factors for iron deficiency, talk to his or her doctor.
Signs and symptoms of iron deficiency anemia might include:
- Pale skin
- Fatigue
- Cold hands and feet
- Slowed growth and development
- Poor appetite
- Abnormally rapid breathing
- Behavioral problems
- Frequent infections
- Unusual cravings for non-nutritive substances, such as ice, dirt, paint or starch
How can iron deficiency in children be prevented?
If you’re feeding your baby iron-fortified formula, he or she is likely getting the recommended amount of iron. If you’re breast-feeding your baby, talk with your baby’s doctor about iron supplementation. An iron supplement may be iron drops given at a specific dose or iron that’s included in a vitamin supplement.
Here are some general recommendations:
- Full-term infants.Start giving your baby an iron supplement at age 4 months. Continue giving your baby the supplement until he or she is eating two or more servings a day of iron-rich foods, such as iron-fortified cereal or pureed meat. If you breast-feed and give your baby iron-fortified formula and the majority of your baby’s feedings are from formula, stop giving your baby the supplement.
- Premature infants.Start giving your baby an iron supplement at age 2 weeks. Continue giving your baby the supplement until age 1. If you breast-feed and give your baby fortified formula and the majority of your baby’s feedings are from formula, stop giving your baby the supplement.
Other steps you can take to prevent iron deficiency include:
- Serve iron-rich foods.When you begin serving your baby solids — typically between ages 4 months and 6 months — provide foods with added iron, such as iron-fortified baby cereal, pureed meats and pureed beans. For older children, good sources of iron include red meat, chicken, fish, beans and spinach.
- Don’t overdo milk.Between ages 1 and 5, don’t allow your child to drink more than 24 ounces (710 milliliters) of milk a day.
- Enhancing absorption.Vitamin C helps promote the absorption of dietary iron. You can help your child absorb iron by offering foods rich in vitamin C — such as citrus fruits, cantaloupe, strawberries, bell pepper, tomatoes and dark green vegetables.
Should I have my child screened for iron deficiency?
Iron deficiency and iron deficiency anemia are typically diagnosed through blood tests. The American Academy of Pediatrics recommends that all infants be tested for iron deficiency anemia starting between ages 9 months and 12 months and, for those who have risk factors for iron deficiency, again at later ages. Depending on the screening results, your child’s doctor might recommend an oral iron supplement or a daily multivitamin or further testing.
Iron deficiency in children can be prevented. To keep your child’s growth and development on track, offer iron-rich foods at meals and snacks and talk to your child’s doctor about the need for screenings and iron supplements.
What Is Iron-Deficiency Anemia?
Iron-deficiency anemia is anemia that happens when there isn’t enough iron in the body.
Someone with anemia has a lower number of red blood cells (RBCs) than usual. RBCs contain hemoglobin, a protein that carries oxygen throughout the body. The body needs iron to make hemoglobin (HEE-muh-glow-bin). Without enough iron, less hemoglobin and fewer red blood cells are made, leading to anemia.
Treatment with iron supplements usually makes the anemia better.
What Are the Signs & Symptoms of Iron-Deficiency Anemia?
At first, children with iron-deficiency anemia may not have any symptoms. When symptoms do happen, a child might:
- look pale
- seem moody
- be very tired
- get tired quickly from exercise
- feel dizzy or lightheaded
- have a fast heartbeat
- have developmental delays and behavioral problems
- want to eat ice or non-food items (called pica)
What Causes Iron-Deficiency Anemia?
Iron-deficiency anemia can happen when:
- There’s a problem with how the body absorbs iron (such as in celiac disease).
- Someone has blood loss from an injury, heavy menstrual periods, or bleeding inside the intestines.
- Someone doesn’t get enough iron in the diet. This can happen in:
- children who drink too much cow’s milk, and babies given cow’s milk before they’re 1 year old
- vegetarians because they don’t eat meat, a source of iron
- breastfed babies who don’t get iron supplements
- babies given formula with low iron
- babies who were born early or small who may need more iron than formula or breast milk contains
How Is Iron-Deficiency Anemia Diagnosed?
Doctors usually can diagnose iron-deficiency anemia by:
- asking questions about symptoms
- asking about the diet
- finding out about the patient’s medical history
- doing a physical exam
- doing blood tests to:
- look at the red blood cells with a microscope
- check the amount of hemoglobin and iron in the blood
- check how fast new RBCs are being made
- do other blood tests to rule out other types of anemia
How Is Iron-Deficiency Anemia Treated?
Doctors treat iron-deficiency anemia with iron supplements taken as a liquid or pill for at least 3 months. To help iron get absorbed into the body:
- Avoid taking iron with antacids, milk, or tea because these interfere with the body’s ability to absorb iron.
- Take iron before eating (unless this causes an upset stomach).
Someone whose anemia is very severe may get iron or a blood transfusion through an IV (intravenous) line.
When iron-deficiency anemia is caused by something other than a lack of iron in the diet, treatment also may include:
- treatments to reduce bleeding in heavy menstrual periods
- reducing the amount of cow’s milk in the diet
- treating an underlying disease
How Can Parents Help?
If your child has iron-deficiency anemia:
- Make sure your child takes the iron supplements exactly as prescribed.
- Include iron-rich foods in the family’s diet. Good sources of iron include:
- iron-fortified cereals
- lean meat, poultry, and fish
- tofu
- egg yolks
- beans
- raisins
- Serve fruits and vegetables high in vitamin C or a glass of orange juice at mealtimes. This helps the iron get absorbed.
- Talk to a dietitian or your doctor if your child is a vegetarian. They can recommend foods to help your child get enough iron.
