Detecting and managing iron deficiency anemia in children

Why should Iron Deficiency or Iron Deficiency Anemia be tested in your children?

Iron Deficiency Anemia is very common in children. Almost 10% of children have Iron Deficiency Anemia in the United Arab Emirates. Some children have iron deficiency without anemia. In the initial stage, they will have iron deficiency without symptoms as mentioned below. Asymptomatic Iron deficiency and Iron
Deficiency Anemia can affect learning capabilities of children in the future. Moreover, it is very easy to be prevented if you plan your children’s diet appropriately. It is very easy to be tested, diagnosed and treated early.

Therefore it is important to make sure that all children have been tested between1 and 3 years of age for Iron Deficiency Anemia and treated as per the American Association of Pediatrics recommendation

What is Iron Deficiency Anemia (IDA) ? 

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to our body. Iron is essential for production of healthy red blood cells. The lack of iron
in the body lead to anemia, called Iron Deficiency Anemia (IDA).

In the initial stages, children might have iron deficiency without symptoms.

What are the causes of IDA?

Lack of enough iron in your child’s regular food is the most common cause of Iron Deficiency Anemia (IDA) in your child. If you fail to start solid food containing iron at 5 – 6 months of age and give only milk, your baby may develop IDA by  the age of one. Toddlers who drink too much cow’s milk may also become iron deficient if they are not eating other foods containing iron

Other rare causes may be:

1. Food digestive pipe is not able to absorb iron well, even though your child is eating food containing enough iron.
2. Slow blood loss over a long period, often due to abnormal menstrual periods or bleeding in digestive pipe.

Toddlers who drink too much cow’s milk may also become iron deficient if they are not eating other foods containing iron.

What are the symptoms and signs of IDA?

Mild anemia may have no symptoms. At later stage, your child may develop following:

• Become Irritable.
• Eat Less Food.
• Feel tired or weak all the time.
• Have sore tongue.
• Have Headache or dizziness.
• Very Pale White of Eyes.
• Get Pale Skin.
• Try to eat items other than food like Paper, Soaps.

What are the blood tests that measure iron level in the body?

Hb, MCV, MCH, Serum Ferritin, Serum Iron, Total Iron Binding Capacity (TIBC), and Iron Saturation.

What are the treatments for Iron Deficiency Anemia (IDA)?

Treatment for Iron Deficiency Anemia in your child usually involves giving iron medicine and modifying your child’s diet to increase iron levels and Hemoglobin in the blood.

Usually it works best when given on an empty stomach. There is no need to stop medicine if you see your child’s stool turning black when they’re taking iron medicine.

Can Iron Medicine be given?

Doctor can prescribe iron medicine in the form of tablet or syrup. Usually it works best when given on an empty stomach. There is no need to stop medicine if you see your child’s stool turning black when they’re taking iron medicine.

Some child can experience side effects with iron treatment, which includes:

• Abdominal (Tummy) pain.
• Constipation or Diarrhea.
• Heartburn & Feeling Sick.
• Black stools.

These side effects should settle down by a few days. If a child has troublesome side effects, you can give medicine with little food or shortly after eating.

What are Iron-rich foods?

Below is the list of foods rich in iron:

•  Dark-green leafy Vegetables
•  Iron-fortified cereals or bread
•  Brown Rice
•  Pulses and Beans
•  Nuts and Seeds
•  White and Red meat
• Fish and Eggs
• Dried fruit, such as dried apricots, dates & raisins.

What other precautions should I take?

Your child’s diet should include foods containing iron as mentioned above. They should also
take food and drink containing vitamin C as vitamin C helps your child’s food pipe absorb more iron.

How does a doctor monitor my child with Iron Deficiency Anemia?

It is important that you take your child to their doctor regularly and check how well your child is responding to the treatment. Your child should continue taking iron medicine till hemoglobin levels and iron levels are normal for at least 3 months. You can see changes in your child such as eating more food, improved behavior, increased activity levels and their skin turns a Healthy pink.

What are the foods, which decreases the iron level in the body?

Consuming large amounts of following foods and drinks may reduce absorption of iron: 

• Tea and Coffee
• Calcium in diary products such as cow’s milk

What can we do if treatment is ineffective?

If your child’s iron levels still haven’t improved, in spite of taking the medicine as prescribed, then your child may need further investigations to find out the reasons.