Iron deficiency is a common but preventable health problem in children. Here is how you can recognize the symptoms of iron deficiency and, more importantly, how you can prevent it.
Symptoms of iron deficiency
The most common illness associated with iron deficiency is anemia, a condition that is characterized by a low level of hemoglobin, which allows oxygen to be carried in the blood. The signs and symptoms of anemia include pale skin, low energy levels, irritability, a fast heart rate, exercise intolerance and, in some children, developmental delay. The body uses iron to produce hemoglobin. As the body becomes depleted of iron, it is unable to make adequate amounts of hemoglobin and anemia develops. Symptoms of iron deficiency are usually not present unless there is anemia. Recent studies show that low iron levels alone can affect brain development even before anemia develops. Since screening all children is neither practical nor desirable (it involves blood testing), prevention of iron deficiency with adequate dietary sources is very important.
Ensure baby gets enough iron
With some exceptions, iron deficiency develops because iron is lacking in the diet. Babies who are born at term have a good supply of iron. Babies will take enough iron from their moms during pregnancy whether mom is anemic or not.
A full-term infant will have enough iron to last for six to nine months after birth. After that, he needs a good source of iron in his diet. The best source of iron is iron-fortified cereal, which should be introduced when your child is between four to six months old, and should remain a staple in your child's diet until he is at least one year old. Babies will still be getting some iron from breast milk at this stage, but will require more in order to meet their needs.
After 12 months of age, babies either continue to breastfeed or switch to drinking whole cow's milk. Excessive intake of milk at this stage can lead to low iron levels for several reasons, one of which is that babies will fill up on milk and not eat other foods. This is most common in babies who use the bottle for comfort. Switching these babies from bottle to cup should help decrease their milk intake. Children at this age should get no more than 16 to 24 ounces of milk per day. Too much cow's milk can also lead to some irritation of the intestines possibly resulting in a small amount of blood loss through the stool - this too will lead to anemia.
For toddlers, meat, poultry and seafood are the best sources of iron. Other sources include iron-fortified cereals, beans, spinach, and tofu. As the iron in meat sources is more easily absorbed, vegetarian children are more likely to need an iron supplement.
If you suspect your child is anemic or iron-deficient, you can easily have him screened with a blood test. If your child's iron levels are low, he will be given a supplement of iron and his levels can be checked again in a few months. In that time, dietary changes can be made, too. It is important to take iron supplements only on the advice of a doctor as there is toxicity with iron overdose! There are other, more rare causes of anemia that your doctor will investigate if iron therapy does not help your child. Remember, prevention is the key!
DR. HESHAM GHAZAL
PROFESSOR OF PEDIATRICS
FACULTY OF MEDICINE