Around of infants aged six to 12 months and 25% of toddlers aged one to two years in Australia don’t get the recommended dietary intake of iron.
Authors
Yianna Zhang
Sessional tutor, The University of Melbourne
Amanda Patterson
Senior Lecturer in the School of Health Sciences, University of Newcastle
Ken Ng
Senior Lecturer & Course Coordinator (Master of Food Science), The University of Melbourne
Despite their small size, weaning infants and children require to adults. The iron is for supporting their rapid growth in blood and muscles, immunity, brain development and learning.
Untreated iron deficiency can progress to anaemia – severe iron deficiency where there are insufficient healthy to carry oxygen around the body. Alarmingly, anaemia affects around of Australian children under five, and if untreated, can be associated with developmental setbacks and later .
How do I know if my kids have iron deficiency?
Iron deficiency in children is often , especially if it has not progressed to anaemia.
Symptoms can include , (eating non-food substances such as paper, clay or soil).
Diagnosis typically involves a blood test that screens for iron markers such as ferritin, a protein that stores iron. Doctors often recommend these tests for people who are at high risk, detailed in the figure below.
What are the first options for treatment?
When iron deficiency and anaemia are caused by a lack of dietary iron, both can often be effectively addressed through and .
The in Melbourne recommends boosting intake of such as meat, fish, eggs, leafy greens and legumes, and drinking less than 500mL (about two cups) of cow’s milk per day. This is because cow’s milk has been associated with in young children.
Doctors might also prescribe oral iron supplements. A course of liquid or tablets would usually be recommended for a minimum of , during which follow-up blood tests can show how well the child is responding to the supplementation.
Existing evidence suggests are a more effective way to replenish iron stores than dietary changes alone, and ferrous sulfate is the most for young children.
Navigating the side effects
Iron supplements are known to have some nasty including constipation, nausea, diarrhoea, dark stools, and stained teeth. This may make compliance challenging, especially for young children. The approaches to alleviate side effects vary depending on the child.
The doctor may recommend alternative supplements as some may be than others. Another option is to adjust the dosage, with lower dose supplements or taking it .
Consuming iron supplements with food or immediately after eating can also . However this may result in reduced absorption, and should be discussed with your doctor.
For cases where iron supplements don’t appear to be working or where compliance is an issue, may be prescribed by your doctor. These involve injecting iron over multiple visits at a hospital and/or specialist clinic, with each session potentially lasting an hour or more.
How can I prevent iron deficiency in my kids?
To prevent iron deficiency, it’s important to keep an eye on your child’s iron intake, and the factors that may influence their absorption.
For example, drinks which contain tannins (tea, coffee, chocolate drinks) may inhibit iron absorption. But vitamin C and organic acids from fruits and vegetables, as well as high-quality proteins such as those found in meat and fish, can .
From infancy, following the will help to support your child’s iron status. This includes introducing iron-rich solid foods from around six months of age for healthy breastfed infants to replenish their iron stores from birth.
Around six months is also the prime time for introducing foods to minimise , including to iron-rich foods such as seafood and nut butters.
From 12 months onwards, children’s diets should align with the , emphasising a balanced, nutritious diet encompassing a range of foods. Diets following this pattern should deliver ample iron from meats, breads and cereals, as well as iron absorption promotors such as oranges, capsicum and other fresh fruits and vegetables?.
In cases where the child is a picky eater, or where access to a diversity of foods is limited, look for fortified iron options such as in bread, drinks (for example juice for , and Milo for older kids), and breakfast cereals.
If your child is diagnosed with iron deficiency, remember each path to recovery is unique. Consultation with a GP or dietitian can help tailor solutions catering to their specific needs.
Yianna Zhang has previously received a postgraduate scholarship from CSIRO, which investigated food-based chemical interactions potentially affecting iron absorption.
Amanda Patterson has previously received funding from the Hunter Medical Research Institute and Meat and Livestock Australia for research on Iron Deficiency.
Ken Ng does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
