• Iron Supplementation In Babies and Children

    What Is Iron?

    Image for childrens iron supplementsIron is a basic metal or mineral. It is also an important part of every cell in the human body. Most importantly, iron is found in the red blood cells where it delivers oxygen to all of the organs and tissues.

    What Happens When the Body Has Low Iron?

    Iron is needed to create new blood cells so a lack of iron can cause a low blood count (called anemia). Anemia is one of the most common nutritional problems worldwide.
    Anemia can lead to a number of problems, including:
    • Decreased energy
    • Fatigue
    • Paleness
    • Problems with concentration
    • Dizziness
    • Feeling faint
    • Shortness of breath
    • Heart palpitations
    Babies and young children need iron for proper growth and development of their entire bodies, in particular their rapidly growing brains. When young children are anemic, they may show delays in normal development. They may have problems in school, including difficulty completing tasks and problems paying attention. Remember, however, that not all children with anemia have the symptoms listed above. Also, some children have low iron levels but have not yet developed anemia.

    Are Some Children at Higher Risk for Anemia?

    Some children are particularly susceptible to becoming anemic. Children who are born prematurely , have a low birth weight, live in poverty, or are recent immigrants have a higher risk of developing anemia. Adolescent girls are at higher risk of anemia due to blood loss from their menstrual periods.

    How Can I Make Sure My Child Is Getting Enough Iron?

    Generally, full-term breastfed babies are thought to receive enough iron in the breast milk for the first four months of life. After that, they will need to be given an iron supplement until they get enough iron from other sources, such as iron-fortified formula or iron-rich food. Formula-fed infants need iron-fortified formula. Once babies are taking solid foods, they should be getting iron-rich food, such as meat or iron-fortified cereal, each day. Premature babies should almost always be given iron supplementation starting at one month of age to 12 months.
    Children under 12 months old should not drink cows milk. Because cow’s milk is a poor source of iron, toddlers are prone to developing anemia if they drink more than 2-3 cups of milk each day. If you restrict how much cow's milk your child drinks, he will be more likely to eat foods higher in iron.
    Your child should have a balanced diet that includes daily portions of iron-rich foods, such as:
    • Liver, beef, poultry, pork, lamb
    • Tuna, salmon
    • Iron-fortified cereals and breads
    • Dried beans, such as limas, soybeans, pinto and kidney beans, split peas, black-eyed peas
    • Whole grains, including wheat, millet, oats, and brown rice
    • Dried fruits, such as apricots, raisins, prunes, dates, peaches
    • Dark green vegetables, including leafy greens like spinach, kale, and collards, as well as broccoli and asparagus
    • Blackstrap molasses
    Interestingly, the body absorbs iron from animal sources (such as meats) better than iron from plant sources. The ascorbic acid of vitamin C also helps the intestine absorb iron more efficiently. Serve iron-rich foods with drinks or foods that are high in vitamin C. Examples include: orange juice, citrus fruits, broccoli, strawberries, and melon.

    Should My Child Be Tested for Anemia?

    Anemia can be easily detected with a simple blood test. Different organizations have different recommendations regarding routine screening for anemia. Often children are checked for the first time at about one year of age, but if your child is at higher risk, he may be checked earlier. Let your child's doctor know if you are concerned that your child has anemia or is at risk for anemia.

    How Much Iron Does My Child Need?

    The exact amount of iron needed in the diets of children varies depending on age and gender. For example, because teen girls lose iron through menstrual blood, they need more iron than teen boys. Here are some basics on how much iron children need at various ages:
    Age of Child
    Girls
    Boys
    7-12 months 11 mg 11 mg
    1-3 years 7 mg 7 mg
    4-8 years 10 mg 10 mg
    9-13 years 8 mg 8 mg
    14-18 years 15 mg 11 mg

    What Should I Do if My Child Is Anemic?

    If your child is anemic, talk to the doctor to make sure that your child is eating a well-balanced diet rich in iron-containing foods.
    If the doctor thinks that your child needs to take iron supplements, you should ask which form of iron your child should take. There are many types of iron preparations on the market, and you may need to try several to find one that your child tolerates. The doctor may encourage you to give your child a food or beverage containing vitamin C along with the iron supplement to improve its absorption. If your child has any stomach upset from the supplement, you may be asked to give smaller doses several times a day.
    If you are giving your child iron supplements, carefully follow the doctor's instructions. Iron at doses higher than the ones listed in the table above can cause serious symptoms in children. Never give more than the amount prescribed, even if you have accidentally missed a dose.

    How Can I Safely Store My Child’s Iron Supplements?

    Iron supplements are a leading cause of poisoning deaths in young children. Even though our bodies need a certain amount of iron, excess iron can kill—especially when small children swallow iron supplements intended for use by adults. To keep your child safe, put the supplements on the highest shelf of your cabinet, preferably in a locked cupboard. The supplement should also be in a marked container with a child-resistant lid.
    If you think that your child may have taken an overdose of iron supplements or other multivitamins that contain iron, immediately contact the Poison Control Center (1-800-222-1222), the doctor, or the nearest hospital’s emergency department.

    RESOURCES

    American Academy of Pediatrics http://www.aap.org/

    United States Department of Agriculture http://www.usda.gov/wps/portal/usdahome/

    CANADIAN RESOURCES

    About Kids Health http://www.aboutkidshealth.ca/

    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

    References

    Anemia—differential diagnosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated September 8, 2011. Accessed April 23, 2012.

    Anemia. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/anemia/DS00321/DSECTION=risk-factors . Updated June 2009. Accessed March 11, 2010.

    Chantry CJ, Howard CR, Auinger P. Full breastfeeding duration and risk for iron deficiency in U.S. infants. Breastfeed . 2007;2(2):63-73.

    Facts about dietary supplements. Office of Dietary Supplements, National Institutes of Health website. Available at: http://www.cc.nih.gov/ccc/supplements/iron.html#rda . Accessed October 8, 2003.

    Feeding your infant: ages 5-8 months. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated March 2010. Accessed March 11, 2010.

    Human nutrition: iron. Ohio State University website. Available at: http://ohioline.osu.edu/hyg-fact/5000/5559.html . Accessed October 8, 2003.

    Iron. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated August 2008. Accessed March 11, 2010.

    Iron. EBSCO Natural and Alternative Treatments website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated February 2010. Accessed March 11, 2010.

    Iron. Office of Dietary Supplements website. Available at: http://ods.od.nih.gov/factsheets/Iron-HealthProfessional/. Accessed April 26, 2012.

    Iron and iron deficiency. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nutrition/everyone/basics/vitamins/iron.html#How much . Updated February 23, 2011. Accessed April 23, 2012.

    Iron deficiency anemia in infants and children: how to prevent it. American Academy of Family Physicians, Family Doctor website. Available at: http://familydoctor.org/online/famdocen/home/children/parents/kidshealthy/nutrition/751.html . Updated February 2010. Accessed March 11, 2010.

    Iron needs of babies and children. Caring for Kids website. Available at: http://www.cps.ca/caringforkids/pregnancybabies/ironreq.htm . Updated April 2007. Accessed March 11, 2010.

    Nelson Textbook of Pediatrics . 16th ed. Philadelphia, PA: WB Saunders Company; 2000: 149-166.

    Recommendations to prevent and control iron deficiency in the United States. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/epo/mmwr . Accessed October 8, 2003.

    10/12/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Baker R, Greer F, the Committee on Nutrition. Clinical report—diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). American Academy of Pediatrics website. Available at: http://pediatrics.aappublications.org/cgi/reprint/peds.2010-2576v1 . Published October 5, 2010. Accessed October 12, 2010.

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