When Your Child Has Iron-Deficiency Anemia

In anemia, there is a lower than normal number of red blood cells (RBCs) and/or a lower level of hemoglobin (a protein that carries oxygen) in the red blood cells. Anemia can be caused by many conditions. In iron-deficiency anemia, the cause of anemia is not having enough iron in the body. RBCs are important because they help carry oxygen throughout the body. If the RBCs or hemoglobin is severely low, the body's cells don't get enough oxygen. If not treated, iron-deficiency anemia can affect your child’s growth, brain function, and development. The healthcare provider will evaluate your child and recommend treatment.

What causes iron-deficiency anemia?

• A low-iron diet

• A diet that is too rich in milk or dairy products

• A digestive problem that affects iron absorption

• Lead poisoning

• Blood loss such as from menstruation or the gastrointestinal tract (milk protein allergy/colitis or inflammatory bowel disease) 

What are the symptoms of iron-deficiency anemia?

Your child may have no symptoms at all. If symptoms are present, they can include:

• Pale skin, lips, and hands

• Low energy and tiredness

• Pica (the tendency to eat nonfood items, such as chalk, clay, or paper)

• Poor appetite

• Slowed growth and development

How is iron-deficiency anemia diagnosed?

The healthcare provider asks about your child’s symptoms, diet, and health history. A physical exam is also done. The healthcare provider will then order lab tests, such as a complete blood cell count to confirm there is anemia. Other tests may be done to learn if the anemia is caused by too low a level or iron. Usually iron-deficiency anemia is diagnosed by a routine blood count test. 

How is iron-deficiency anemia treated?

Treatment choices include the following: 

• The healthcare provider may prescribe oral iron supplements to increase the iron your child gets. It may take 1 to 3 months for your child’s RBC count to return to normal. Don't give your child iron supplements without a healthcare provider’s supervision. Too much iron can lead to serious health problems in your child. In some cases, iron may need to be given through an IV. 

• You may need to give your child more foods that are rich in iron. The body tends to absorb iron from meat better than iron from nonmeat foods. This includes beef, fish, chicken, turkey, and pork. Nonmeat foods that are good sources include iron-fortified breads or cereals, tofu, peas, lentils, raisins, dried fruits, sweet potatoes, greens, beans, or peanut butter.

• Vitamin C helps the body absorb iron because it creates an acidic environment in the gastrointestinal tract which increases iron absorption. Vitamin C can be found in vegetables and fruits, especially citrus fruits.

• If the cause is heavy menstrual flow, birth control pills may be prescribed to regulate the menstrual cycle and reduce blood loss. 

• If your child’s RBC count is very low, blood transfusions may be needed.

How is iron-deficiency anemia prevented?

Ways to prevent iron-deficiency anemia include the following: 

• If possible, breastfeed your baby for at least 12 months. Starting at 4 to 6 months of age, give your baby plain, iron-fortified infant cereal and/or pureed meat. Just 2 or more servings a day can meet a baby's iron needs at this age.

• When your baby is about 6 months of age, include a feeding per day of foods rich in vitamin C with foods that are rich in iron to improve iron absorption.

• Don't give children age 1 to 5 years more than 24 ounces of cow, goat, or soy milk per day.

• Make sure your child has a well-balanced diet with foods rich in iron.

• If your child is formula-fed, ask your healthcare provider to recommend iron-rich formulas. These can help with growth and development. Also ask about iron-rich baby foods for when your child is ready to eat solids.