What Causes Iron Deficiency in Your Child – and How To Spot It

Contributor: Kadakkal Radhakrishnan, MD

Iron is essential for your child’s development, and an iron deficiency can affect your child’s health and growth — and can even lead to anemia.

Iron deficiency anemia is relatively common among children and occurs when hemoglobin in the blood is less than the optimal level. Iron deficiency usually occurs for three main reasons:

1. Poor diet. Children are at higher risk for iron deficiency because of their higher need for iron. Simply put, a diet that’s poor in sources of iron can lead to iron deficiency. And don’t overdo the milk! A diet that features an excess amount of milk, which is a poor source of iron, can place a child at risk for iron deficiency.
2. Loss of blood. Causes of blood loss can range from a stomach ulcer (which is not common in children) to chronic bowel inflammation to a parasitic infestation like hook worm.
3. Inability to absorb adequate iron from food. This can occur with conditions such as celiac disease or Crohn’s disease.

Signs and symptoms of iron deficiency

Several signs can signal if your child may have an iron deficiency:

• Overall lack of energy and fatigue.
• Pale appearance as hemoglobin levels drop.
• Nails that appear brittle, tongue that looks redder than normal and/or cracks on the side of the mouth.
• Poor appetite or a craving to eat non-food items like ice, dirt, paint or starch.

Children with iron deficiency also can be at higher risk for lead poisoning and infection.

Diagnosis and treatment

Diagnosing an iron deficiency requires an assessment of your child by his or her pediatrician. The assessment involves going over a detailed history, nutritional intake, a physical examination and finally, a lab test that involves a complete blood count, including hemoglobin level, assessment of iron status and body stores that involve special tests.

While the most common cause of iron deficiency is inadequate dietary intake, these tests are necessary to precisely identify the deficiency’s cause.

Treatment of iron deficiency typically involves iron supplements – which may include prescription medications. This will take up to three months of treatment.

At the same time, the physician will likely evaluate and treat any underlying condition that may lead to malabsorption of iron or blood loss.

Although more rare, in an instance where the child’s hemoglobin levels become too low, they may require blood transfusions or therapy with iron injection or intravenous iron therapy. These are treatments that take place in a hospital.

Overall, families dealing with iron deficiencies may benefit from the help of a pediatric dietitian to improve the dietary intake of iron-containing food. Vitamin C can also help improve absorption of iron – so this supplement could be valuable in conjunction with iron-rich foods.