Keeping Kids Healthy
By Drs. Sally Robinson and Keith Bly 

Iron deficiency anemia is the world’s most common single-nutrient deficiency.

Iron is a mineral needed by our bodies. Iron is part of all cells and does many things in our bodies.

One way it is used is as part of the protein hemoglobin which carries oxygen from our lungs throughout our bodies. Too little hemoglobin is called anemia. Iron also helps our muscles store and use oxygen.

Iron is part of many enzymes and is used in many cell functions. Enzymes help our bodies digest food and also help in with many other important reactions.

When the human body is deficient of iron, it is of concern because it can do the following:

• Iron deficiency can delay normal infant motor function (normal activity and movement) or mental function (normal thinking and processing skills).

• Iron deficiency during pregnancy can increase the risk of having small or preterm babies.

• Iron deficiency can cause fatigue that impairs the ability to do physical work in adults and may also affect memory and other mental function in teens.

Young children and pregnant women are at higher risk of iron deficiency because of rapid growth and higher iron needs.

Among children, iron deficiency is seen most often between 6 months and 3 years of age because of rapid growth and inadequate intake of dietary iron.

Infants and children who are at the highest risk are the following:

• Babies who were born early or small;

• Babies given cow’s milk before 12 months old;

• Breast-fed babies who after 6 months are not given plain iron-fortified cereals or another good source of iron-rich foods;

• Formula-fed babies who are not fed iron-fortified formulas;

• Children ages 1-5 who get more than 24 ounces of cow, goat or soy milk per day;

• Children who have special health care needs such as chronic infection or restricted diets.

Universal screening for anemia should be preformed at about 12 months old.

The most common screening is a hemoglobin test which measures the hemoglobin protein that carries oxygen to your body. However, these tests are not usually decreased until the later stages of iron deficiency.

How to prevent iron deficiency? Eat iron-rich foods. For babies, if possible, breast feed your baby for at least 12 months and starting at 4 to 6 months, give your baby iron-fortified cereal and/or puréed meat. Just two servings a day should meet your baby’s needs.

Also at 6 months, begin a food rich in vitamin C which improves iron absorption. If you can’t breast feed, use an iron-fortified formula until at least 12 months old.

Ask your doctor about iron drops if your baby was premature, born small or if he or she cannot get two or more servings a day of fortified cereal or puréed meats.

You can also ask your doctor for a list of iron-rich foods and vitamin C-rich foods. Remember that too much iron can also be dangerous.

The effect of iron deficiency on mental functions may not be reversible with iron treatment so it is better to prevent it in the first place.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital, and Keith Bly is an associate professor of pediatrics and director of the UTMB Pediatric Urgent Care Clinics. This column isn’t intended to replace the advice of your child’s physician.