Why children often lack iron
The child grows quickly, blood volume increases, and the need for iron turns out to be higher than in an adult at the same weight. Reserves accumulated in utero are depleted by the middle of the first year of life, so complementary feeding with iron-rich foods is critical. The risk is higher in premature babies and twins. A separate common mistake is the early and abundant introduction of whole cow's milk: it is poor in iron, impairs its absorption and can cause microblood loss from the intestines. In adolescents, rapid growth, restrictive diets and menstrual losses in girls are added.
- Rapid growth and increased blood volume
- Prematurity and low birth weight
- Late introduction of complementary meat
- Excess whole cow's milk up to two years of age
- Restrictive and unbalanced diets in adolescents
- Heavy menstruation in girls
- Worm infestation and chronic blood loss
How does anemia manifest?
Symptoms increase gradually, and parents often attribute them to character or age. The child gets tired faster, tolerates outdoor games worse, becomes irritable and absent-minded, and the student’s academic performance drops. Pale skin is not always noticeable, but the pallor of the mucous membrane of the eyelids and nail beds attracts attention. With severe iron deficiency, perversions of taste and smell appear: a desire to eat chalk, earth or ice, a craving for the smell of paint. Hair and nails often suffer, and jams appear in the corners of the mouth.
- Fatigue, lethargy, moodiness
- Decreased attention and performance
- Pale skin and mucous membranes
- Poor appetite and food selectivity
- Desire to eat chalk, earth, ice
- Brittle nails, hair loss, seizures
- Shortness of breath and palpitations on exertion
- Frequent colds
Diagnostics
They start with a general blood test: it shows the level of hemoglobin and the characteristics of red blood cells, which can suggest the type of anemia. With iron deficiency, red blood cells are small and pale. A key indicator of iron stores is ferritin, but it increases with inflammation, so it is assessed along with C-reactive protein. Reticulocytes indicate how actively the bone marrow is making new cells. If the picture is not typical for iron deficiency, the doctor excludes thalassemia, hemolysis, vitamin B12 and folic acid deficiency, and hidden blood loss.
- General clinical blood test with erythrocyte indices
- Ferritin as a marker of iron stores
- Serum iron and iron binding capacity
- Reticulocytes
- C-reactive protein to assess inflammation
- Feces for occult blood and helminth eggs
- Vitamin B12 and folic acid according to indications
Treatment
For iron deficiency anemia, iron supplements are prescribed orally in a dose calculated for the child’s weight. Hemoglobin usually begins to increase after 2–4 weeks, but treatment does not end there: the treatment is continued for several more months to replenish reserves in the depot, otherwise anemia quickly returns. Control tests are done at the times prescribed by the doctor. Intravenous iron is rarely used and only for special indications. At the same time, they eliminate the cause: they treat helminthic infestation, adjust the diet, and in case of blood loss, look for its source.
- Oral iron supplements for several months
- Take between meals with water or juice, not milk or tea.
- Control of tests within the time prescribed by the doctor
- Treatment of the cause: parasites, blood loss, intestinal diseases
- Intravenous iron - only as directed by your doctor
- Blood transfusion - for severe anemia in the hospital
Nutrition and prevention
Nutrition does not replace the treatment of already developed anemia, but plays a decisive role in prevention. Iron from meat, liver and fish is best absorbed, while plant iron from cereals, legumes and greens is absorbed less well - its absorption is improved by foods with vitamin C. Tea, coffee and large amounts of dairy products, on the contrary, interfere with absorption, so they are taken at the same time as main meals. For children at risk, the pediatrician may prescribe preventive iron supplementation.
- Meat, liver, fish, eggs in the complementary diet
- Buckwheat, legumes, greens along with vegetables and fruits
- Whole cow's milk - no earlier than a year and in moderation
- Don't drink tea with food
- Preventive iron supplementation in premature infants as prescribed by a doctor
- Regular monitoring of blood tests within prescribed periods