Iron Deficiency

Iron deficiency is a relatively common nutrient deficiency that can cause a contiditon called anemia. We test for this at your baby’s 6 month and 12 month visits, then generally every 2 years or so thereafter.

What is Iron?

Iron is a mineral that is found in many foods including meat, beans, and vegetables. The body uses iron to make hemoglobin, an important part of red blood cells. Hemoglobin carries oxygen to cells around the body.  All cells in the body use iron as well.

What is Anemia?

Anemia is a condition when the body’s hemoglobin level is too low. There are many different causes of anemia in children. A common cause of anemia is iron deficiency. Children with iron-deficiency may have low energy, pale skin, poor sleep, and irritability, but many do not show these symptoms or these symptoms may be attributed to “normal” baby/childhood development. Iron-deficiency anemia can negatively affect brain development.  Your child can also be iron deficient without having anemia.

Why are Young Children at Risk for Iron-Deficiency Anemia?

During pregnancy, iron is transferred from the mother to the baby through the placenta. Babies are usually born with enough iron in their body to prevent iron deficiency for many months. Eventually, though, the infant will need to get iron through the diet.

Breast milk contains only a small amount of iron and also contains a chemical called lactoferrin which is designed to prevent excess iron in the gut (bacteria like iron as much as our cells do). Formula is generally fortified with iron, with the goal of reducing the risk of anemia.

Many baby and toddler foods are also low in iron or contain excessive calcium (which binds to the iron and then is excreted in stool). Adding to the issue, only 1mg of iron is absorbed for every 10-20mg of iron ingested.

Dysbiosis (imbalanced gut microbiome) can also contribute to poor iron absorption.

How Can I Prevent/Reduce Iron Deficiency in My Child?

Eat Iron-Rich Foods

As your child grows, continue to incorporate iron rich foods every day.  These foods include:

  • Meat & Poultry – beef, pork, lamb, organ meats (liver, kidney), dark meat chicken & turkey, duck
  • Seafood – clams, mussels, oysters, sardines, anchovies
  • Lentils, Legumes & Beans – black, kidney, lima, navy, pinto, black eyed peas, soy beans, baked beans, green peas, chickpeas
  • Dark leafy greens – spinach, kale, collards, mustard, turnip, swiss chard
  • Broccoli, Cabbage, Brussel Sprouts
  • Yeast-leavened whole-wheat bread & rolls
  • Iron-fortified cereals, pasta, rice, and breads
  • Dried fruit – raisins, apricot, prune
  • Seeds – Pumpkin, sesame, hemp, flaxseed
  • Nuts & Nut-butters – Cashew, Pistachio
  • Whole grains – amaranth, spelt, oats, quinoa
  • Egg yolk
  • Blackstrap Molasses
  • Olives
  • Dark Chocolate & Cocoa Beans/Nibs
  • Coconut Milk

Improve the Absorption of Iron from Foods

Calcium containing foods reduce the amount of iron that is absorbed in a meal.  Avoid calcium containing foods at the same time as iron containing foods.  Ingredients in tea (and coffee for you parents) also reduces the absorption of iron from food.  Vitamin C helps the body to better absorb dietary iron. Offer your child vitamin C rich foods along with iron containing foods, including:

  • Citrus Fruits (oranges, tangerines, lemons, limes, etc)
  • Tomatoes, tomato sauce
  • Strawberries and other berries, Papaya, Cantaloupe, Pineapple
  • Bell Peppers (red, green); Broccoli; Green leafy veggies; Sweet potatoes

Other tips

  • Cook with an iron skillet or an “iron fish” [some of the iron leaches into the food]
  • Grind up meats [may increase the absorption and bioavailability of the iron]
  • Make eating these foods fun and kid friendly. Offer foods multiple times.  Role model good eating habits by eating these foods as well!
    • Spaghetti sauce with meat, sprinkled with thyme
    • Hummus with carrots and bell pepper strips
    • Add chopped greens to mac ‘n’ cheese and scrambled eggs
    • Trail mix with nuts, raisins, prunes, dried apricots, pumpkin seeds, sunflower seeds, dark chocolate
    • Gingerbread made with whole grains and blackstrap molasses {google for recipe}
    • Oatmeal with blackstrap molasses
    • Smoothies made with coconut milk, veggies, flax seed and berries
    • Add beans to tacos, nachos, chili (mash up if necessary)
    • Nut-butter sandwich with iron fortified whole grain bread
    • Serenity Baby Food beef pouch or similar
  • Cow’s milk is a poor source of iron and can prevent the body from absorbing iron from other foods. Do not feed your child cow’s milk before age 1. After age 1, do not let your child drink more than 16-18 ounces of milk daily.
  • Take a probiotic containing multiple strains of lactobacillus and bifidobacter, with a CFU of 5-25 billion.
  • Taking too much iron can be harmful, so make sure to only take a supplement with iron only as directed by your provider. Keep all iron products out of reach of children.