Diagnosis and Prevention of Iron Deficiency or Anemia in Infants and Children

What is iron deficiency?

• Iron is a very important nutrient required for the healthy growth of children
• Healthy red blood cells require iron to form haemoglobin which carries oxygen from the lungs to all the tissues and organs in the body
•Depletion of iron will reduce the formation of haemoglobin causing iron deficiency anemia which will impede adequate oxygenation of tissues leading to disruption of normal physical and mental growth
• Iron deficiency is caused by – eating a diet poor in iron, blood loss from the gastrointestinal tract (ulcers, polyps, cows milk protein allergy) and unable to absorb iron (inflammatory bowel disease)

Who is at risk for iron deficiency?

• Premature or low birth infants
• Babies who are not started on complimentary food by 6months
• Babies who are not breast fed and are on formulas not enriched with iron
• Babies who are introduced to cows milk before 1 year of age
• Toddlers who drink more than 2-3 cups of milk
• Children with any form of chronic illness
• During the first stages of puberty especially adolescent girls who are not eating an iron rich diet

What are the Symptoms of Iron Deficiency (Anemia)

• Pale skin and mucus membranes
• Fatigue (tiredness)
• Shortness of breath (especially while climbing stairs) and dizziness
• Palpitations (being aware of the heart pounding)
• Poor appetite
• Slowed growth and behavioural problems
• Increased incidences of infections
• Craving to eat non edible substances such as paint , chalk, dirt, mud etc. – called as pica

How Is Iron-Deficiency (Anemia) Diagnosed?

• Your doctor may get a detailed diet history of your family and child
• A thorough physical exam may reveal pale mucus membranes , pale nail beds with brittle nails, smooth tongue, fissures at mouth corners, an enlarged spleen and an abnormal hearth rhythm or murmur
• Your child will require a blood test to check the level of hemoglobin and iron stores
• Stool test – to look for any microscopic blood loss from the gastrointestinal tract

How is Iron-Deficiency (Anemia) treated?

• Your doctor may prescribe some iron supplement pills or syrup which are best taken on an empty stomach or with some citrus juice rich in vitamin C which helps with iron absorption
• Feed your child iron rich foods:
• Egg yolks
• Lean red meats ( lamb ), seafood (tuna, salmon, shrimp ) and liver
• Iron-fortified breads and cereals
• Peas, lentils – white and red kidney beans (Rajma), soybeans and chickpeas (Channa)
• Dried fruits, such as dates, raisins, and prunes, nuts
• Spinach and other dark green leafy vegetables
• Tofu

How Can Iron-Deficiency Anemia Be Prevented?

• Breast feed babies until 1 year or use iron fortified milk formula and do not introduce cow milk before 1 year as it is low in iron
• Start complimentary feeding by age 6 months with iron fortified cereals or homemade iron rich foods
• Ideally, it is recommended to do a blood test to look for iron deficiency in babies between 9-12 months
• Encourage children to have a balanced diet rich in iron and vitamin C
• Ensure your kids have no more than 2 cups of milk a day
• Keep your well child visits with the doctor allowing to screen regularly for iron deficiency , growth and development
• Take iron supplements whenever recommended by your doctor