Anemia And Children

Some Toddlers at Greater Risk for Iron Deficiency

As toddlers progress from babies to big kids, they tend to drink more milk and become ever more finicky about what they put in their tiny mouths. That's why the 1- to 3-year-old age range is also prime time for little ones to potentially develop iron deficiency — a problem that affects 2.4 million U.S. kids.

And, according to a new study, certain toddlers are at especially high risk of not getting enough iron (also called iron deficiency, when the body's iron stores have become depleted).

Looking at Centers for Disease Control and Prevention (CDC) data about blood tests taken from 1,641 1- to 3-year-olds, the researchers found that toddlers are:
* Nearly three times as likely to be iron deficient if they're overweight (20%) than normal weight (7%).
* Twice as likely to be iron deficient if they aren’t in day care or preschool (10%) than those who are (5%).
* Twice as likely to be iron deficient if they're Hispanic (12%) than if they're white or black (6% in both groups).

An essential part of child's regular diet, iron is needed to make hemoglobin, the oxygen-carrying component of red blood cells. Red blood cells circulate throughout the body to deliver oxygen to all its cells. Without enough iron, the body can't make enough red blood cells and the body's tissues and organs won't get the oxygen they need to function well.

It's all-too-common for toddlers to not get nearly enough iron because:

After 12 months old, kids no longer drink iron-fortified formula and may not be eating iron-fortified infant cereal or enough other iron-containing foods.
They may drink a lot of cow's milk, which is low in iron and may make them less hungry and less likely to eat iron-rich foods. Plus, milk decreases the absorption of iron and also can irritate the lining of the intestine in some kids, causing small amounts of bleeding and the gradual loss of iron in the stool (or poop).

A Closer Look at Iron Deficiency

On top of possibly affecting a child's growth, iron deficiency may lead to long-term learning and behavioral problems if it isn't caught early.
And it can progress to iron-deficiency anemia, a condition marked by a decrease in the number of red blood cells.

Unfortunately, because the body's iron supply is depleted slowly, a lot of kids with iron-deficiency anemia don't have any obvious signs and symptoms, so it can be hard to detect. But as the anemia gradually gets worse, kids may experience:
fatigue and weakness
pale skin and mucous membranes
rapid heartbeat or a new heart murmur
decreased appetite
dizziness or a feeling of being lightheaded
What This Means to You

You can find the essential nutrient in various kinds of foods, but the iron in meat sources is absorbed more easily by the body than the iron in plant foods.
Some excellent sources that you can incorporate — or even sneak — into your family's everyday diet include:
- lean meats (like red meat, dark poultry)
- tuna and salmon
- egg yolks
- tofu
- dried beans, peas, and fruits
- leafy green vegetables (like spinach and broccoli)
- blackstrap molasses
- whole-grain breads
- iron-fortified breakfast cereals (preferably whole-grain, low-sugar varieties)

To make extra sure kids are getting enough iron at every age, it's also wise to:
Continue offering iron-fortified infant cereal until 18 to 24 months old.
1. Keep milk to a minimum — no more than 16 to 24 fluid ounces (473 to 710 milliliters) a day.
2. Serve iron-rich foods along with those rich in vitamin C (like tomatoes, broccoli, oranges, and strawberries) to help the body absorb more iron.
3. Avoid serving coffee or tea at mealtime, which can reduce iron absorption.
4. Monitor the iron intake of vegetarian kids and young athletes, who may require 5. extra iron in their diets.
6. Make sure teens are getting enough iron. Teen girls, especially, need additional iron to replace what they lose each month when they menstruate.
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If you're concerned that your child isn't getting enough iron, talk to your doctor, who may run simple tests and prescribe iron supplements, if needed. But never give your child iron supplements without consulting your doctor first — too much iron can actually harm your child's health.

Reviewed by: Steven Dowshen, MD
Date reviewed: October 2007

Source: "Iron Deficiency in Early Childhood in the United States: Risk Factors and Racial/Ethnic Disparities," Pediatrics, September 2007.