IRON DEFICIENCY ANEMIA IN CHILDREN
Iron deficiency anemia (IDA) is recognized as a global public health concern. According to Vietnam’s National Institute of Nutrition, between 2015 and 2016, 27.8% of children under 5 years old were anemic, with 63.6% of cases caused by iron deficiency.
12/3/2024 3:16:11 PM
A 2020 study on children aged 12 to 36 months in Hanoi reported a 14.2% prevalence of iron deficiency and 8.5% for iron deficiency anemia. Furthermore, the SEANUTS 2022 survey found that 59% of Vietnamese children do not get enough iron from their daily diets.
1. Risk factors for iron deficiency anemia in infants and young children
Newborns:
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Maternal iron deficiency anemia during pregnancy
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Premature birth or low birth weight
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Issues such as twin-to-twin transfusion, or fetal-maternal hemorrhage
Infants (under 1 year):
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Insufficient iron supplementation in exclusively breastfed babies
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Consumption of cow’s, goat’s, or soy milk without added iron and minerals
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Poor dietary practices, such as inadequate iron-rich complementary foods
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Feeding challenges like picky eating or difficulty transitioning to solids
Children aged 1–12 years:
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Excessive cow’s milk intake
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Diets lacking sufficient iron-rich foods
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Picky eating or following a vegetarian diet
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Medical conditions impacting iron absorption or blood loss:
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Chronic infections or inflammation
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Celiac disease, inflammatory bowel disease
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Gastrointestinal bleeding or other conditions causing blood loss
2. Signs of iron deficiency anemia in children
In its early stages, iron deficiency anemia may show no visible symptoms, with changes detected only in blood tests (microcytic, hypochromic anemia). Symptoms develop gradually and depend on the severity of iron deficiency:
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Mild Symptoms: Low energy, pale or slightly yellowish skin, pica (e.g., eating dirt).
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Severe Symptoms: Fatigue, irritability, enlarged heart, poor appetite, and rapid breathing in severe anemia cases.
Other signs may include:
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Neurological: Crying easily, irritability, reduced focus, tiredness, forgetfulness, dizziness, or headaches.
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Muscular: Delayed motor milestones (sitting, standing, walking), low muscle tone, or bloated abdomen.
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Hematological: Low hemoglobin levels (<11 g/dL), pale complexion, enlarged liver/spleen in infants, and weakened red blood cells.
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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
For infants (up to 12 months old):
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Exclusively breastfeed for 4–6 months. Breastmilk contains a small amount of iron (0.3–1 mg/L) but is highly bioavailable.
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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.
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Iron-fortified formula: If using formula, choose one containing >6.7 mg/L of iron. Avoid low-iron formulas.
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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.
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Avoid raw cow’s milk until 12 months old: It can increase hidden blood loss in the gut.
For children aged 1–5 years:
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Limit cow’s milk to no more than 600 ml/day. Consuming over 720 ml daily increases the risk of iron deficiency.
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Incorporate at least three servings of iron-rich foods daily.
By following these steps, you can help your child maintain healthy iron levels and support their growth and development!