Iron produces the pigment hemoglobin which is the component of the red blood cells responsible for carrying oxygen throughout the body. A lack of iron causes the blood disorder known as iron-deficiency anemia.
This is the most common kind of anemia in children. Up to ten percent of young children in the United States are iron deficient, and the condition occurs most frequently between the ages of 6 months and 24 months. Iron-deficiency anemia is usually simple to treat. Medication with iron supplements leads to a rapid and complete recovery. More importantly, however, most cases can be prevented with adequate nutrition.
WHEN SHOULD I SUSPECT THAT MY CHILD HAS IRON-DEFICIENCY ANEMIA?
Anemia develops so gradually that even the most conscientious parent can overlook the early signs. If your child seems pale, less alert, and more easily fatigued than other children, take a closer look. Check the color of the insides of the eyelids and lips, the nail beds and the creases of the palm; in anemia, these areas are unnaturally pale. Finally, review your child's diet to make sure he is eating iron-rich foods or drinking an iron-fortified formula.
WHAT CAUSES IRON-DEFICIENCY ANEMIA?
Most cases of iron-deficiency anemia in early childhood can be traced to an iron-poor diet. The typical diet of a very young child—low in iron-rich foods like meat and vegetables and high in milk and cereals—cannot provide sufficient quantities of iron. Low-birth-weight babies are particularly susceptible because they have less iron stores to begin with and experience rapid growth spurts. Also common is bleeding from the bowel due to early introduction of whole cow's milk into the diet. The amount of blood lost may be too small to see, but over time it may lead to significant iron loss and anemia.
IS MEDICAL ATTENTION NECESSARY?
Yes. A child with iron deficiency should be treated by a physician. Don't attempt to medicate your child with iron if you suspect anemia. Excess consumption of iron can be more harmful than iron deficiency. Also, the same symptoms can signal other, more serious problems that require different treatment.
HOW CAN THE DOCTOR TELL IF MY CHILD HAS IRON-DEFICIENCY ANEMIA?
Your pediatrician uses various laboratory tests to diagnose iron-deficiency anemia and—equally important—identify the cause of the deficiency. Most likely, insufficient iron in the diet or blood loss will be the culprit. When the cause is unclear, however, your doctor will want to perform more tests to rule out other problems, such as an ongoing blood loss.
WHAT TREATMENTS ARE AVAILABLE?
The doctor will probably prescribe daily iron supplements, usually taken in a liquid form with meals. (Although iron absorption is better if the medication is given between meals, it can cause stomach upset.) A complete recovery can be expected within two to four weeks. Iron therapy should continue for another six months, however, to replenish your child's iron stores. Finally, getting on track with a healthy diet is a critical part of maintaining your youngster's health. The best management of iron-deficiency anemia is prevention.
PREVENTING IRON-DEFICIENCY ANEMIA
Breast-fed babies should be given iron supplement drops to prevent anemia. Commercial infant formulas are supplemented with iron, therefore, bottle-fed babies do not need these supplements. Since whole milk can cause the mild intolerance that leads to anemia, do not give it to a baby under one year of age.
After one year of age, if your toddler would rather fill up on milk than eat iron-rich solid foods, begin to limit the volume of milk to encourage a more varied diet.
Fussy eaters can be nudged along with a little imagination. Add an extra egg yolk to pancake batter. Add extra red meat or green vegetables in a favorite soup or stew. Offer special "treats" of little boxes of raisins or dried apricots.
Cooking in cast-iron pots, especially such foods as tomato sauce, can add significant amounts of iron to your child's diet.
Offer your child plenty of citrus juices and fruits (vitamin C increases absorption of iron, while milk decreases absorption).
IRON-RICH FOODS Very Good:
• Liver
• Beef
• Beans
• Prune Juice
Good:
• Avocado
• Blueberries
• Poultry
• Peas
• Iron-fortified formulas, cereals and breads
• Whole-grain cereals and breads
• Green leafy vegetables
• Potatoes with skin
• Dried apricots and raisins
GETTING HELP
Call your doctor if your child:
• Is pale, listless or irritable
• Tires easily
• Seems more susceptible to infections
• Has decreased appetite
• Develops a craving for ice cubes, dirt, clay or other nonfoods.
