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Iron
The importance of iron for infants and preschoolers
Iron is a mineral that infants and children need for growth, health and development. Most iron in the body is found in hemoglobin, the part of red blood cells which carries oxygen, but some is located elsewhere in body tissues.
How does iron deficiency develop?
When iron is lacking in the body, the person is said to have iron deficiency. This most often occurs in two stages. In the first, the body’s stores of iron are reduced. This shows up only on special blood tests designed to estimate the amount of iron present.
In the second stage, which is iron deficiency anemia, the body’s iron has decreased so much that the red blood cells become pale, small and fewer in number. This means the blood cannot carry as much oxygen as it should. A child with low iron levels may be irritable, lethargic, pale and prone to infections, but often has no symptoms.
Why does iron deficiency develop?
There are three main causes which your family doctor will look at while investigating iron deficiency in a child.
- Poor intake - What is the infant or child eating? Does the child’s diet include a good supply of foods rich in iron?
- Decreased absorption - Is the iron taken in a form that is easily absorbed? What is the source of the iron? Are other foods present which either increase or decrease iron absorption? Are there other medical problems which reduce absorption? (eg. celiac disease)
- Increased needs - Does the child have an increased need for iron? Increased losses of iron (eg. from recurrent nose bleeds or blood loss in the stool) or infections (eg. bowel parasites) can increase a child’s iron needs.
Is lack of iron common?
This is the most common nutrient deficiency in the world. In Vancouver, seven per cent of otherwise healthy 9-month-old infants had iron deficiency anemia and 24 per cent had low iron stores. In disadvantaged infants in Montreal, the percentages were 27 per cent and 37 per cent. Infants who were born prematurely have a greater risk of iron deficiency.
Is it serious?
Iron deficiency is not only common - it can be very serious. If iron is lacking, oxygen may not be carried through the blood stream properly and the heart and lungs have to work harder than usual. As a result, an infant may tire quickly and have less energy to play, learn and develop.
People often think of iron deficiency as a problem of the blood cells but it can affect other body systems as well. Iron deficiency can interfere with the immune system, the digestive system and the development of a child. A young child who has iron deficiency and is exposed to certain bacteria may not be able to fight off infection as well as a child who has normal levels of iron.
Researchers have also learned that iron deficiency has a negative impact on the digestion of some foods. Iron deficiency may even cause damage to the lining of the bowel, which shows up as loss of a small amount of blood in the bowel movement. Perhaps of even more concern, many infants found to have iron deficiency anemia have low scores on developmental testing and the scores may not improve even after iron therapy is started, at least in the short term.
Can I tell if my child has iron deficiency?
Iron deficiency can be diagnosed only through blood tests. These check the level of hemoglobin, the microscopic appearance of red blood cells or serum ferritin. Parents, doctors or nurses may suspect iron deficiency if a child is irritable, tired and pale. However, some infants who are lacking in iron may be quite chubby and placid. Doctors and nurses refer to these infants as ‘milk-fed babies.’ They are babies who have had only unmodified cow’s milk, without adequate dietary iron sources, and who are deficient in iron. These babies are chubby because they get lots of calories from cow’s milk but they are pale and unhealthy because they lack iron.
Can iron deficiency be prevented?
The good news about iron deficiency is that while it is a common and serious problem, it can be prevented. Some ways in which it can be prevented are:
- breastfeeding during the baby’s first six months or more
- using iron-fortified formula after breast feeding has stopped until 12 months of age
- adding high-iron foods such as iron-fortified cereals by six months of age
- adding foods rich in Vitamin C before six months of age to increase iron absorption
- delay in adding whole cow’s milk (homo milk) until 12 months of age (do not give skim or partly skimmed milk to infants)
Pre-schoolers will be less likely to develop iron deficiency if they have good body iron stores from infancy. As well, there are other measures to prevent iron deficiency in young children. They include:
- offering a variety of iron-rich meat, fish, poultry and soybeans, or fruits and vegetables that have iron
- avoiding foods that interfere with iron absorption (such as too much dietary fibre or tea)
- where possible, avoiding parasitic infections by practising good sanitation
Can iron deficiency be treated?
Iron deficiency is usually easy to treat once diagnosed. Treatment in infants and children consists of avoiding practices that commonly lead to iron deficiency and providing iron drops. (These should be given under the direction of a doctor).
Healthy habits in infant and child feeding will prevent most iron deficiency. Should the problem develop the treatment is most successful if started in the iron deficiency stage before the development of obvious anemia. Some researchers warn that if treatment is left until the iron deficiency is too severe, developmental problems may not be totally reversible.
Your family doctor may suggest a blood test to rule out iron deficiency at around nine months of age. By making sure that your infant or pre-schooler is receiving enough iron and having a hemoglobin test, you will be helping your child avoid iron deficiency.
Iron is present in foods in different forms. Animal products contain heme or ferrous iron, which is more readily absorbed by the body. Vegetables, fruits, breads and cereals contain non-heme or ferric iron which is not absorbed as well. Vitamin C helps increase iron absorption.
Good Food Sources of Iron
SOURCES OF
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SOURCES OF
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SOURCES OF BOTH HEME IRON AND NON-HEME IRON |
SOURCES OF VITAMIN C |
Liver, especially pork, kidney, heart, beef, pork, veal, lamb, liverwurst, braunschwieger sausage, fish (clams, oysters, sardines) |
Dried fruit (raisins, apricots), iron supplements, eggs, whole grain cereals, enriched cereals and pasta, dark leafy green vegetables (beet greens, chard, kale, spinach) |
Beans with tomato sauce and pork, spaghetti and meat sauce, chili con carne with beans, cabbage rolls with meat |
Citrus fruit, broccoli, cauliflower, green pepper, strawberries, potatoes, fortified juices |
FAMILY HEALTH is written with the assistance of |
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FAMILY HEALTH is written with the assistance of |
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