Prevent Iron Deficiency in Infants and Toddlers

The number of children ages one to three years of age with iron deficiency seems to be increasing according to Louis A. Kazal M.D. of the Najajo Health Foundation. Iron deficiency can affect a child’s growth and may lead to learning and behavioral problems. It can also progress to anemia, which is a decreased number of red blood cells in the body. Iron is needed to make red blood cells, which carry oxygen throughout the body. Without enough iron and red blood cells, the body’s tissues and organs get less oxygen and don’t function as well.

Louis A. Kazal M.D. goes on to say the primary focus should be preventing iron deficiency anemia infants and toddlers by providing healthy feeding practices. In infants, the introduction of cow’s milk in the first year of life is the greatest dietary risk factor for the development of iron deficiency and iron deficiency anemia. Cow’s milk is low in iron, and its iron is poorly absorbed. In addition, it decreases the absorption of iron from other dietary sources. Therefore strict avoidance of cow’s milk in the first 12 months is essential in preventing iron deficiency anemia. To prevent iron deficiency, another option is a daily oral iron supplement, using ferrous sulfate drops or infant vitamin drops with iron.

Breastfeeding is the ideal feeding practice for many well-documented reasons, including lowering the risk of iron deficiency anemia. Although breast milk is low in iron content, about 50 percent of the iron is available to the infant. Yet, exclusive breastfeeding after four to six months puts infants at risk for iron deficiency. Therefore some form of dietary iron supplement may be needed.

According to Kids Health after 12 months of age, toddlers are at risk for iron deficiency because they no longer drink iron-fortified formula and may not be eating iron-fortified infant cereal or enough other iron-containing foods to make up the difference.

Drinking a lot of cow’s milk (more than 24- 36oz) also can put a child a risk of developing iron deficiency. Toddlers who drink a lot of cow’s milk may be less hungry and less likely to eat iron –rich foods. Milk decreases the absorption of iron and can also irritate the lining of the intestine, causing small amount of bleeding and the gradual loss of iron in the stool.

To help prevent iron deficiency:

• Limit your child’s milk intake to about 16-24 ounces per day.
• Increase iron-rich foods (meat, poultry, fish, enriched grains, beans, tofu, leafy green vegetables) in your child’s diet.
• When serving iron-rich meals, include foods the contain vitamin C (tomatoes, broccoli, organs, strawberries), which improve the body’s iron absorption.
• Continue serving iron-fortified cereal until your child is 18-24 months of age.
• Never give you child a vitamin or mineral supplement without fist discussing it with child’s doctor.

Louis A. Kazal Jr. M.D. is a Robert Wood Johnson health policy fellow at the Institute of Medicine in Washington D.C. and is chief medical officer of the Navajo Health Foundation/Sage Memorial Hospital in Ganado, Arizona.

By Kathleen Cleary, R.N.
Child Care Nurse Consultant
Carol Robertson Center for Learning, SDA 6