What is iron? Why is it important?
Iron is a mineral our body uses to make hemoglobin, a protein in the red blood cells that carries oxygen. It is also in muscle cells as myoglobin. Some iron is stored in the body as ferritin.
Children need adequate iron for growth and development.
How much iron do children need?
The recommended daily allowance (RDA) for iron varies by age and sex.
RDA for Iron: Age Male Female Birth to 6 months 0.27 mg 0.27 mg 7–12 months 11 mg 11 mg 1–3 years 7 mg 7 mg 4–8 years 10 mg 10 mg 9–13 years 8 mg 8 mg 14–18 years 11 mg 15 mg * 19–50 years 8 mg 18 mg* Pregnancy 27 mg
*women need higher amounts due to blood loss from menstruation
What are signs in children with low iron?
Iron deficiency is a common problem in kids. It can lead from mild symptoms to iron deficiency anemia.
Common symptoms include:
Fatigue
Pale skin
Cold hands and feet
Poor appetite
Decreased performance in sports
Unusual cravings for non-food items such as ice, dirt, or starch
Slowed growth and development
Behavior problems
Difficulty concentrating
Who is at risk for iron deficiency?
Babies born prematurely
Babies who drink cow or goat milk before a year of age
Babies who drink formula not fortified with iron
Babies who are exclusively breastfed after 6 months without being given iron-fortified foods
Children who drink excessive milk (cow, goat, or soy) greater than 24 ounces daily
Picky eaters who don’t eat enough iron-rich foods
Menstruating girls
Children with chronic health conditions or those on restricted diets
Children living at high altitudes
Children exposed to lead
Vegans and vegetarians
How do you check iron levels?
A simple blood test can measure iron and ferritin levels. Babies are screened for anemia at their one-year well-child check with a finger stick test for hemoglobin and lead in their doctor’s office. If either is abnormal, additional tests will be ordered through a lab.
How do we get iron in our diet?
There are two forms of iron from food: heme iron from animal sources (meat, poultry, and seafood), and non-heme iron from plants. Heme iron is better absorbed by the body than non-heme iron.
Adding vitamin C-rich foods in combination with iron sources increases absorption.
Calcium-rich foods combined with iron sources decrease absorption.
Foods High in Iron
Iron Sources:
Meat and Poultry
Lean beef
Veal
Pork
Lamb
Chicken
Turkey
Liver (except fish liver)
Seafood
Fish
Mussels
Shellfish
Plant Sources
Legumes - beans, peas, lentils
Soybean products
Nuts and seeds
Leafy greens
Potatoes
Mushrooms
Tomato paste
Dried apricots, prunes, raisins, dates
Olives
Whole grains - amaranth, spelt, oats, quinoa
Fortified cereals
Tofu
Broccoli
Brussel Sprouts
Bean Sprouts
Green Beans
Corn
Beets
Cabbage
What about iron supplements?
Children at risk for iron deficiency should likely take iron supplements but check with your child’s doctor. I typically recommend that girls take a multivitamin with iron once in puberty. Some children with ADD/ADHD have been found to have low iron or ferritin, so consider checking for this. Children who follow a vegan or vegetarian diet should also be monitored.
Iron in the form of ferrous sulfate is more bioavailable than ferric sulfate.
Gummy vitamins typically do NOT contain iron.
Children's vitamins should be kept out of reach and never be called candy. Too much iron is toxic.
Too much iron is dangerous, so supplements should be out of sight and out of reach with a childproof cap. Vitamins should never be called candy. Check with your doctor on the exact dosing.
Can iron deficiency be prevented?
YES! Prevention is the best medicine!
Iron deficiency is one of the most preventable health conditions in the world.
Premature infants usually need an iron supplement starting at 2-3 weeks, when their iron stores are depleted. They should be supplemented until a year.
Full-term infants on iron-fortified formulas do not need a supplement. Breastfed babies may need to be supplemented at 3 months until they are on iron-rich foods.
Don’t let your toddler overdo the milk! Limit the amount to 2-3 cups a day. This amount will meet their calcium and vitamin D requirements.
Consider an iron supplement or a multivitamin with iron for girls in puberty.
Be sure to serve iron-rich foods once your infant begins solids and beyond. Offer with vitamin C-rich foods when able.
Consider having your child tested if they are at risk.
Know the risks of iron deficiency, what to watch for, and how to prevent this common health problem.