Iron Deficiency & Anemia among Children

Iron deficiency is one of the most common forms of malnutrition in children, especially among those under 24 months of age, affecting the function of blood, brain tissues and muscles. Severe iron deficiency leads to anemia, manifested by low blood levels (low Hb, depending on age groups).

Why are children often at risk of iron deficiency and anemia?

Children, especially those under 24 months of age, run the highest risk of iron deficiency and anemia because of their high growth rate as well as inadequate daily iron intake.

What are the symptoms of iron deficiency and anemia?

• Hypertension, loss of appetite, pale skin. If the child is suffering from severe anemia, he or she gets exhausted easily, having high heart rate, large and swelling heart.
• Long-term effects on physical and cognitive development; deterioration in the function of their immune system.
• Iron deficiency may not cause anemia but still contributes to delayed growth.

When should children be screened for iron deficiency and anemia?

1. All 12 month-old children (American Academy of Pediatrics)
2. Children with risk factors: 1st time: 9-12 months of age, 2nd time: 6 months later and then every year (2-5 years of age):

• Preterm (< 37 weeks) or underweight children
• Children who use cow’s milk early, before 12 months of age
• Children who are breast-fed but not fed with iron-rich foods after 6 months of age
• Formula breastfeeding but with lack of iron
• Children aged 1-5 years who use more than 600 ml of cow’s milk, goat’s milk, soy milk every day
• Children with chronic inflammatory diseases or dietary restrictions
• Children exposed to lead (1-5 years old)
• Children with delayed growth
• Other risk factors related to pregnancy and perinatal period: maternal anemia during pregnancy, uncontrolled gestational diabetes, multiple pregnancy, low socioeconomic status ...

For early detection of iron deficiency and anemia, parents need to have the doctors examine their children and do a blood test so that they can consult on nutrition and timely intervention.

Foods children should avoid if they suffer from iron deficiency and anemia

Calcium-containing foods

One of the major causes of anaemia is iron deficiency and hence, children suffering from this type of anemia are advised not to eat calcium-rich foods. This is because, calcium interferes with the absorption of iron in the body thereby worsening the condition. Foods packed with calcium include milk and milk products like cheese, yoghurt, nuts and bananas.

Tannin-rich foods

Children suffering from iron-deficiency anaemia should restrict their intake of these foods, as they contain tannins, a compound that interferes with the absorption of iron. Foods that are loaded with tannins include grapes, corn and sorghum.

Gluten-containing foods

Foods rich in gluten should be avoided by children suffering from anaemia as it may worsen the condition. Gluten, in some children, damages the intestinal wall preventing absorption of iron and folic acid, both of which are required for the production of red blood cells (RBCs). Gluten is mainly found in pasta, wheat products, barley, rye and oats.

Phytate-rich foods

Phytates usually bind with the iron present in the digestive tract thereby preventing its absorption. Therefore, children with iron-deficiency anaemia are advised to avoid foods containing phytates or phytic acid like legumes, brown rice, whole-grain wheat and nuts.

Oxalic acid foods

In some cases, foods containing oxalic acid are known to interfere with the absorption of iron. Due to this, children with anemia are advised to consume these foods in limited quantities and if possible stay away from them during the course of medication. Foods containing oxalic acid are peanuts, spinach, parsley (ajwain) and chocolates.