Anemia is very commonly seen in young children who are mainly on milk based diet (As milk is poor source of iron). Breast milk has small quantity of iron but it is readily absorbed in body; so for first 6 months of life iron deficiency is not prominent. But after 6 months, when top milk is started, it can lead to anemia if proper iron supplementation or appropriate weaning food is not given.
That is the very reason you will see all the infant formula feeds and cereals fortified with iron these days. As iron is needed to make Hemoglobin; which is oxygen carrying component of red blood cells (RBCs).
What is the right Quantity of Iron needed by my Kid?
- From birth till 6 months: Adequate iron is there in mother’s breast milk. No need for supplementation unless baby is preterm or suffering from any illness.
- 7 -12 months: 11mg per day. It can be given by using infant formula feeds or cereals fortified with Iron or using iron supplement drops.
- Toddlers: 7 mg/day; Kids aged 4-8 years need around 10 mg per day. Older kids between 9- 13 years need around 8 mg/day.
- Adolescent boys need 11 mg /day and girls 15 mg/day of iron. Girls need more during their adolescence as more blood is lost during menstruation.
- Special need in athletes and children involving extreme physical activities need even more iron.
How deficiency develops?
- Infants and young children mainly on cow’s milk develop iron deficiency as cow’s milk is low in iron and it also makes child less hungry and there is a less likelihood of child eating iron rich foods.
- Cow’s milk also decreases absorption of iron and can irritate lining of intestine causing minor intestinal bleeding and gradual loss of Iron in stool.
- Worm infestation
- Iron requirement is more than normal in certain conditions like preterm babies, menstruating adolescent girls, children involved in extreme physical activities.
What are Effects of iron Deficiency?
- Poor appetite
- Poor growth and development
- Behavioral problems
- Fatigue and weakness
- Pale skin and mucous membranes
- Rapid heartbeat or a new heart murmur (detected in an exam by a doctor)
If any of the above symptoms is there in your child, consult your child specialist / Pediatrician and discuss regarding iron deficiency and need for supplementation. Excess of iron is also bad, so it should be taken in appropriate doses only after consulting your child doctor.
Common source of Iron in Diet
Both animal and plant source foods are available which are rich in Iron
- Red meat
- Dark poultry
- Enriched grains
- Dried beans and peas
- Dried fruits
- Leafy green vegetables
- Blackstrap molasses
- Iron-fortified breakfast cereals
How to avoid Iron Deficiency in your child
- Limit the intake of milk: 500 to 700 ml a day after 1 year of life and focus on staple diet.
- Continue serving iron-fortified cereal until kids are 18-24 months old.
- Avoid giving iron supplements with milk as leads to poor absorption.
- Serve iron-rich foods alongside foods containing vitamin C — such as tomatoes, broccoli, oranges, and strawberries — which improves the body’s absorption of iron.
- Avoid serving coffee or tea at mealtime — both contain tannins that reduce iron absorption.
Once Iron is started in Iron deficient child; within 2 -3 days you will see significant improvement in diet.
Dr Rahul Varma