Iron-Deficiency Anemia in Children
is a common health problem in children. The most common cause of anemia is not getting
enough iron. A child
have enough red blood cells or enough hemoglobin. Hemoglobin is a protein that lets
blood cells carry oxygen to other cells in the body. Iron is needed to form
Iron-deficiency anemia can be
Diets low in iron. A
child gets iron from the food in
only a small amount of the iron in food is actually absorbed by the body.
- Full-term newborns, born to
parents, have iron that they get during the last 3 months of
- Infants of
parents with anemia or other health problems may not have
enough iron stored. And infants born early may not get enough iron.
- At 4 to 6 months of age, the
iron stored during pregnancy is at a low level. And more iron is used as the
- The American Academy of
Pediatrics (AAP) advises feeding your baby only breastmilk for the first 6
months. But breastmilk
have a lot of
are breastfed only, may not have enough iron.
- Older infants and toddlers may
not get enough iron from their diets.
Body changes. When the
body goes through a growth spurt, it needs more iron for making more red blood
Poor absorption of iron is common
after some forms of
surgeries. When you eat foods containing iron, most of the iron is
absorbed in the upper small intestine. Any abnormalities in the
tract could alter iron absorption and cause iron-deficiency anemia.
Blood loss. Loss of
blood can cause a decrease of iron. Sources of blood loss may include
bleeding, menstrual bleeding, or injury.
These are the most common symptoms
of iron-deficiency anemia:
- Pale skin
- Being grouchy
- Lack of energy or tiring easily
- Sore or swollen tongue
- Enlarged spleen
- Wanting to eat odd substances, such as
dirt or ice (also called pica)
In most cases, anemia is diagnosed
with simple blood tests. Routine anemia screening is done because anemia is common
children and they often have no symptoms.
- The AAP recommends anemia
screening with a hemoglobin blood test for all infants at 12
screening should also include a risk assessment. This is a group of questions to find
risk factors for iron-deficiency anemia. Risk factors include feeding problems, poor
growth, and special healthcare needs.
- If the hemoglobin level is low, more
blood tests are done.
- If your child has a risk factor at any
age, blood tests are done.
- Blood tests for anemia may also be
done during routine physical exam or checkups in children of any age.
Most anemia in children is
diagnosed with these blood tests:
This is often the first screening test for anemia in
children. It measures the amount of hemoglobin and red blood cells in the blood.
Complete blood count
A complete blood count checks the red and white blood cells, blood
clotting cells (platelets), and sometimes, young red blood cells (reticulocytes). It
includes hemoglobin and hematocrit and more details about the red blood cells.
Peripheral smear.A small sample of blood is examined under a microscope. Blood cells are checked
to see if they look normal or not.
Iron studies. Blood
tests can be done to measure the amount of iron in your child's body.
Treatment will depend on your
child’s symptoms, age, and general health. It will also depend on how severe the
To prevent iron-deficiency anemia,
the AAP says:
are only breastfed or
breastfed should be given a daily iron supplement until they begin eating iron-rich
need iron supplements. The formula has iron added to it. Whole milk
be given to infants less than 12 months old.
- Infants and toddlers from 1 to 3 years
old should have foods rich in iron. They include cereal that has iron added, red
meats, and vegetables with iron. Fruits with vitamin C are also important.
C helps the body absorb the iron.
Treating iron-deficiency anemia
Iron supplements. Iron
drops or pills are taken over several months to increase iron levels in the blood.
Iron supplements can irritate the stomach and discolor bowel movements. They should
be taken on an empty stomach or with orange juice to increase absorption. They are
much more effective than dietary changes alone. If the child can’t take drops or
(intravenous) iron may be
Iron-rich diet. Eating a
diet with iron-rich foods can help treat iron-deficiency anemia. Good sources of iron
- Iron-enriched cereals, breads,
pasta, and rice
- Meats, such as beef, pork, lamb,
liver, and other organ meats
- Poultry, such as chicken, duck,
turkey, (especially dark meat), and liver
- Fish, such as shellfish,
including clams, mussels, and oysters, sardines, and anchovies
- Leafy greens of the cabbage
family, such as broccoli, kale, turnip greens, and collards
- Legumes, such as lima beans and
green peas; dry beans and peas, such as pinto beans, black-eyed peas, and
canned baked beans
- Yeast-leavened whole-wheat bread
Iron-deficiency anemia may cause delayed growth and development.
You can often prevent iron-deficiency anemia through screening and
taking iron supplements.Watch
how much cow's milk your child drinks.
too much cow's
(more than 32 ounces a day) can prevent the
absorption of iron from other foods and limit the intake of other foods that are rich
When to Call a Healthcare Provider
Call your child's healthcare provider if your infant
nursing well. Or if your toddler or child has any of the signs of iron-deficiency
- Iron-deficiency anemia is not having
enough iron in the blood. Iron is needed for hemoglobin.
infants should be given iron
- When infants are 12 months old, they
should be screened for iron-deficiency anemia.
and iron-rich foods are used to treat iron-deficiency anemia.
Tips to help you get the most from
a visit to your child’s healthcare provider:
- Know the reason for the visit and what
you want to happen.
- Before your visit, write down
questions you want answered.
- At the visit, write down the name of a
new diagnosis, and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment
is prescribed and how it will help your child. Also know what the side effects
- Ask if your child’s condition can be
treated in other ways.
- Know why a test or procedure is
recommended and what the results could mean.
- Know what to expect if your child does
not take the medicine or have the test or procedure.
- If your child has a follow-up
appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s
provider after office hours. This is important if your child becomes ill and you have
questions or need advice.