IRON DEFICIENCY ANEMIA IN CHILDREN

1. Risk factors for iron deficiency anemia in infants and young children 

• Maternal iron deficiency anemia during pregnancy 

• Premature birth or low birth weight 

• Issues such as twin-to-twin transfusion, or fetal-maternal hemorrhage 

• Insufficient iron supplementation in exclusively breastfed babies 

• Consumption of cow’s, goat’s, or soy milk without added iron and minerals 

• Poor dietary practices, such as inadequate iron-rich complementary foods 

• Feeding challenges like picky eating or difficulty transitioning to solids 

• Excessive cow’s milk intake 

• Diets lacking sufficient iron-rich foods 

• Picky eating or following a vegetarian diet 

• Medical conditions impacting iron absorption or blood loss: 

• Chronic infections or inflammation 

• Celiac disease, inflammatory bowel disease 

• Gastrointestinal bleeding or other conditions causing blood loss 

2. Signs of iron deficiency anemia in children 

• Mild Symptoms: Low energy, pale or slightly yellowish skin, pica (e.g., eating dirt). 

• Severe Symptoms: Fatigue, irritability, enlarged heart, poor appetite, and rapid breathing in severe anemia cases. 

• Neurological: Crying easily, irritability, reduced focus, tiredness, forgetfulness, dizziness, or headaches. 

• Muscular: Delayed motor milestones (sitting, standing, walking), low muscle tone, or bloated abdomen. 

• Hematological: Low hemoglobin levels (<11 g/dL), pale complexion, enlarged liver/spleen in infants, and weakened red blood cells. 

• Children with IDA are also more prone to infections due to reduced transferrin and lactoferrin levels. Other symptoms can include brittle hair, nail deformities, and bone pain. 

3. Recommended dietary guidelines to prevent iron deficiency 

• Exclusively breastfeed for 4–6 months. Breastmilk contains a small amount of iron (0.3–1 mg/L) but is highly bioavailable. 

• Iron supplementation: Begin at 4 months for full-term infants (1 mg/kg/day, up to 15 mg) or at 2 weeks for preterm infants (2 mg/kg/day, up to 15 mg). Continue until adequate dietary iron is introduced. 

• Iron-fortified formula: If using formula, choose one containing >6.7 mg/L of iron. Avoid low-iron formulas. 

• Introduce iron-rich foods at 4–6 months: Examples include iron-fortified cereals (two servings/day) and pureed meats. Include a serving of vitamin C-rich foods daily to boost absorption. 

• Avoid raw cow’s milk until 12 months old: It can increase hidden blood loss in the gut. 

• Limit cow’s milk to no more than 600 ml/day. Consuming over 720 ml daily increases the risk of iron deficiency. 

• Incorporate at least three servings of iron-rich foods daily.