Healthy Blood, Happy Kids: Tackling iron deficiency anemia
8/5/2024 by Asma Ali, M.B.B.S.
What is iron deficiency anemia?
Iron deficiency anemia occurs when a child's body lacks enough iron to produce adequate hemoglobin, the substance in red blood cells that carries oxygen. Daily requirements of iron are fulfilled by iron rich foods in the diet. It's a common problem in children and can affect their growth and development. This is why it is important to recognize the problem and treat it in a timely manner.
Symptoms of iron deficiency
- Fatigue and weakness.
- Pale skin.
- Shortness of breath.
- Dizziness or lightheadedness.
- Slow growth and development.
- Behavioral issues (irritability, lack of concentration).
- Unusual cravings for things that contain few or no nutrients — such as ice, dirt, paint or starch.
How is iron deficiency anemia diagnosed?
To diagnose iron deficiency anemia, one or more of the following tests may be performed by your healthcare team:
- Complete Blood Count (CBC): This test measures the levels of red blood cells and hemoglobin. If your child has anemia, this number will be low.
- Serum Ferritin Test: This test measures stored iron and will be low in iron deficiency anemia.
- Serum Iron and Total Iron-Binding Capacity (TIBC): This test evaluates iron levels and capacity to carry iron.
- Reticulocyte Count: This test measures young red blood cells to assess bone marrow function.
How is iron deficiency anemia treated?
- Oral Iron Therapy: Iron supplements are usually the first line of treatment. Supplements should be prescribed by your healthcare clinician and are available as ferrous sulfate, ferrous gluconate or ferrous fumarate. They are commonly prescribed as 3-6 mg of elemental iron per kilogram of body weight per day, divided into two or three doses, taken on an empty stomach for optimal absorption. They can be taken with food to avoid stomach upset. Vitamin C (orange juice) can enhance absorption. Side effects include nausea, constipation, dark stools and stomach cramps. Adjustments in dosage or formulation can help mitigate these effects.
- Intravenous (IV) Iron Therapy: If oral iron is ineffective, not tolerated, or if rapid replenishment is needed, your healthcare clinician may prescribe IV iron therapy which may include iron sucrose, ferric gluconate and iron dextran. IV therapy is given under medical supervision, typically in a clinic or hospital. While the benefit of this therapy is faster improvement in iron levels and symptoms, the risks include possible allergic reactions, including anaphylaxis, although very rare.
Dietary recommendations
- Iron-Rich Foods: Red meat, poultry, fish, beans, lentils, tofu, spinach and iron-fortified cereals.
- Enhancing Absorption: Pairing iron-rich foods with vitamin C-rich foods (e.g., oranges, strawberries) can improve absorption.
- Avoiding Inhibitors: Limit intake of calcium-rich foods, tea and coffee around mealtimes, as they can inhibit iron absorption.
Follow-up and monitoring
Regular follow-up with a healthcare clinician is crucial to monitor the effectiveness of treatment and to adjust as necessary. Blood tests will help track improvements in hemoglobin and iron levels.
Asma Ali, M.B.B.S., was a third-year resident in the Department of Pediatrics at Mayo Clinic in Rochester, Minnesota, at the time this article was written. She is now a Pediatric Hematology/Oncology and Genetics fellow at Mayo Clinic.