Iron deficiency is one of the most common nutritional problems in children. Do you know if your child is getting enough?
Iron is a mineral found in food that is essential for formation of hemoglobin which carries oxygen throughout the body. Food sources of iron will either contain heme or non-heme iron. Heme iron is found in animal foods such as meat, poultry, fish and eggs (yolk) and is the best absorbed form of the mineral. Non-heme iron comes from plant sources such as lentils, beans, grains, nuts/seeds, dried fruit and leafy greens. Non-heme sources are not as well absorbed as heme sources. Almost double the amount of iron would be needed to reach optimal levels when the iron is coming from plant sources. Eating plant sources of iron with vitamin C rich foods, however, will aid in its absorption.
Babies are born with a certain amount of iron stores. These iron stores begin to deplete around the age of 6 months, but sooner for premature infants. At that point, iron-rich foods and/or iron supplements* should be introduced or an iron deficiency can develop. Deficiencies in babies and children can affect their development, physically and mentally. Severe deficiencies can cause anemia, but many symptoms of low iron can appear much earlier, as the iron stores are depleting.
There are many factors which can affect your child's iron levels, including genetics, health conditions and specific dietary concerns. For example, children who drink too much milk are at greater risk of iron deficiency. This is because high calcium intake can interfere with iron absorption, plus, children will often fill up on milk, leaving less room for iron-rich foods.
Those with a higher risk for iron deficiency include:
- Premature babies
- Babies born with a low birth weight
- Babies who drink cow's milk before the age of one
- Children who drink an excessive amount of milk
- Children with vegetarian/vegan diets
- Children with gastrointestinal disorders such as celiac disease, Crohn's/colitis
- Adolescent girls due to blood loss during menstruation
- Family history of anemia
Signs of deficiency may include any or all of the following symptoms:
- Pale skin
- Lack of energy/fatigue
- Low body temperature
- Poor appetite
- Slow weight gain/weight loss
- Decreased immune function leading to frequent colds/infections
- Difficulty concentrating/behavioural problems, which can interfere with performance at school
Ask your doctor/pediatrician for a blood test if you suspect your child could have an iron deficiency. Your doctor will check the hemoglobin levels, but make sure the ferritin levels are also checked. This will indicate if their iron stores are depleted.
Here are some tips to prevent iron deficiency:
- If possible, breastfeed until the age of one. Breast milk is relatively low in iron, but it is very well absorbed. If breastfeeding is not an option, give iron-fortified formula until the age of one.
- Avoid giving cow's milk or milk alternatives until after the age of one.
- After the age of six months, include iron rich foods into your child's diet.
- Offer iron rich foods with vitamin C sources to enhance absorption.
- Cook food in cast iron pots/pans as this increase the iron content of your food.
* Iron supplements may be recommended in certain cases such as low birth weight/preemies, difficulties with absorption or restricted diets. Speak to a healthcare practitioner to find out if this is appropriate for your child, and what the proper dosage would be.
Aviva Allen, RHN, is a Toronto-based nutritionist specializing in prenatal, infant and child nutrition. Click here for more information about nutritional consultations for children.