What is iron deficiency and what are its symptoms in children?
Iron deficiency that something that you may have heard mentioned a lot before but what does it mean? It is the most common mineral deficiency in the world, but fortunately it is often easy to treat with the help of nutrition and supplements. This mineral has many functions in the body, and a deficiency occurs when we aren’t getting enough of it through our diet. It is used to make new red blood cells, it is a part of a protein called haemoglobin which transports oxygen around the body. Iron helps to store oxygen muscles for physical activity. Iron is also important for proper immune function and the development of the brain. If the body isn’t getting enough iron and the body’s stores become depleted, it results in the body not being able to produce enough blood cells and this is called iron deficiency anaemia (National Health Service, 2021). Symptoms of iron deficiency include fatigue, paleness, muscle weakness, light headedness and many more. Babies how are iron deficient may develop pale skin, low to no appetite, irritability, and slow weight gain (Canadian Paediatric society, 2007). However, it is important to note often children won’t show symptoms of iron deficiency until they become anaemic (Mayo Clinic, n.d.). As children grow and develop, they require more energy and nutrients to support this. Their muscle mass and blood volume increase which will result in higher iron requirements. Iron deficiency is diagnosed by a blood test that can be done at your local GP surgery.
What are the risk factors for iron deficiency in children?
A common reason behind iron deficiency anaemia is if cow’s or goats’ milk is consumed before the age of 1. While Breast milk is low in iron it absorbed and used efficiently (Booth, Aukett and Logan, 1997), therefor it is important for babies who aren’t breastfed receive formula that is fortified with iron instead of substituting breastmilk with other milks like cows or plant milks which are low in iron. Babies who are born prematurely or with a low birth weight are at a higher risk due to them not developing sufficient iron stores that will last them until weaning begins. Other factors that increase the risk of developing iron deficiency are if a child have certain health conditions, have been exposed with lead, aren’t eating enough iron-rich foods or have restricted diets, and children who are overweight or obese. (Mayo Clinic, n.d)
Iron requirements for children:
0-3 months - 1.7mg/day
4-6 months - 4.3 mg/day
7-12 months - 7.8mg/day
1-3 years - 6.9 mg/day
4-6 years - 6.1 mg/day
7-10 years - 8.7 mg/day
11-18 years (females) - 14.8 mg/day
11-18 years (males) - 11.3 mg/day
Babies will rely on their iron stores up to 6 months of their age and then they must start receiving iron through oral intake. Iron requirements shift based on what developmental stage the child is at. Adolescent girls who have high menstrual losses will require more iron than 14.8 mg/day.
(British Nutrition Foundation, 2021)
Nutritional treatment for iron deficient children
Iron deficiency is treated with supplements and proper nutrition. Someone who is diagnosed with iron deficiency will be recommended to take an iron supplement to make sure that iron stores are replenished as quickly as possible. Focus should be on meals and snacks that are high in iron as this will support replenishment of stores while helping to prevent deficiency in the future.
How much iron is too much iron?
If iron intake is too high, it may result in iron poisoning. The safe While iron poisoning in children through a typical diet isn’t common, they are at higher risk for it due to accidentally ingesting a high volume of iron supplements. Symptoms of iron poisoning include abdominal pain, vomiting, diarrhoea and low blood pressure. If you suspect your child has iron poisoning medical treatment should be sought out immediately.
Foods high in iron (animal sources, plant sources)
There are two types of iron which are haem iron and non-haem iron. Haem iron is better absorbed than non-haem iron and can primarily be found in animal sources like red meat and liver. Non-haem iron is found in plants like kidney beans and dried apricots. A good way to increase the absorption of non-haem iron is by adding foods that are high in vitamin C like red peppers, tomatoes, and citrus fruits (Lynch and Cook, 1980)
Animal sources high in iron:
- Liver
- Red meat
- Fish
- Poultry
Plant sources high in iron:
- Pulses and legumes (e.g., kidney beans)
- Dark green vegetables
- Nuts and seeds
What about children who follow vegan or vegetarian diets?
A common concern is that children who follow these diets are at a much higher risk of becoming iron deficient. While this may be true due to these diets being naturally lower in iron and non-haem iron which lower absorbency it is possible to ensure your child is meeting their requirements by proper nutritional planning. Ensuring that they are eating a variety of foods that are high in iron and pairing them with vitamin C and consuming fortified products are good places to start.
How to limit the risk of iron deficiency in children?
It is important to limit cows’ milk to about 2-3 cups per day as it is low in iron and lowers the absorption of iron. Babies who aren’t breast fed should be given formula instead of other milks like cows or plant milks as these do not suit their requirements. Children shouldn’t be given tea as it has tannins which are biomolecules that inhibit the absorption of iron (Parkin and Maguire, 2013).
Some easy snacks/meals packed with iron.
- Cereal (iron fortified) with chopped up dried apricots/prunes
- Liver pate on seeded crackers/toast
- Spaghetti Bolognese with kidney beans
- Kale and chickpea pesto with lentil pasta
- Porridge with pumpkin seeds and dark chocolate chips
Should I give my child iron supplements if they are not iron deficient?
If your child is eating a varied and balanced diet it is unlikely that they would require additional supplementation unless they are at risk for iron deficiency. Seek the guidance of an expert such as a HCPC Registered Dietitian if you are considering starting your child on iron supplements.