iron deficiency children, Causes of iron deficiency in children, What is anemia and what causes it?,

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My baby seems pale and weak. Could it be anemia?

Yes. In fact, the most typical signs of anemia are pale skin and tiredness. Other signs include rapid heartbeat, irritability, loss of appetite, brittle nails, and a sore or swollen tongue. But it’s common for a baby with anemia not to have any symptoms at all.
What is anemia, and what causes it?

People become anemic when red blood cells don’t carry enough oxygen to the tissues in their body. Various conditions can cause anemia, including an inherited illness called sickle cell anemia, but iron deficiency is the most common cause.

The human body needs iron to make hemoglobin, the oxygen-carrying red pigment in blood. If your baby doesn’t get enough iron, he’ll have fewer red blood cells and the ones he has will be smaller, so his body tissues will receive less oxygen than they should.

Children are especially susceptible to anemia during periods of rapid growth, when they need extra iron that they don’t always get. But iron-deficiency anemia doesn’t happen overnight — it’s caused by a relatively severe deficiency that develops over time.

Iron deficiencies can happen for several reasons, including not enough iron in the diet, ongoing blood loss (in the intestinal tract, for example), and poor absorption of iron.
Is anemia dangerous?

It can be. In addition to the symptoms mentioned above, a child who’s anemic could suffer permanent mental and physical problems. (While an iron deficiency can be corrected, the mental and physical impairment is not always reversible.) Iron deficiency also makes kids more susceptible to lead poisoning and infection.

Iron deficiency – children

Iron is an important dietary mineral that is involved in various bodily functions, including the transport of oxygen in the blood. This is essential in providing energy for daily life. Iron is also vital for brain development.

Babies, toddlers, preschoolers and teenagers are at higher risk of iron deficiency, mainly because their increased needs for iron may not be met by their diets. Without intervention, a child whose diet does not provide them with enough iron will eventually develop iron deficiency anaemia. See your doctor if you suspect your child may be iron deficient.

Warning!
Iron is toxic in large doses. Avoid the temptation to self-diagnose and give your child over-the-counter iron supplements, because an overdose of iron can cause death. In infants and young children, 20mg per day is the safe upper limit – most iron supplements contain around 100mg per tablet! It is important to keep iron supplements tightly capped and away from children’s reach, as iron tablets are often mistaken as lollies by children. If you suspect an iron overdose, call your doctor or the Poisons Information Centre on 13 11 26 immediately or visit your local hospital emergency department.

Signs and symptoms
The signs and symptoms of iron deficiency anaemia in children can include:

* Behavioural problems
* Repeat infections
* Loss of appetite
* Lethargy
* Breathlessness
* Increased sweating
* Strange ‘food’ cravings (pica) like eating dirt
* Failure to grow at the expected rate.

Causes of iron deficiency in children
Major risk factors for the development of iron deficiency in children include:

* Prematurity and low birth weight
* Exclusive breastfeeding beyond six months
* Introduction of cows milk as the main drink before 12 months
* High intake of cows milk
* Low or no meat intake
* Poor diet in the second year of life
* Possible gastrointestinal diseases
* Lead poisoning.

Babies, children and teenagers undergo rapid growth spurts, which increase their need for iron. The main causes of iron deficiency in children by age group include:

* Babies less than six months old – newborns receive their iron stores in the uterus (womb), which means the mother’s diet during pregnancy is very important. Low birth weight or premature babies are at increased risk of iron deficiency and will need iron supplements (under medical supervision only). See your doctor for further advice.
* Babies aged six months to one year – baby’s iron stores run low in the second half of their first year. Iron deficiency can result if their diet doesn’t include enough iron-rich solid food. At age six months, two servings per day of plain, iron-fortified infant cereal can start to be given. Around approximately seven to nine months of age, plain pureed meats can be offered. Late introduction of solids into the baby’s diet is a common cause of iron deficiency in this age group.
* Children aged one to five years – breast milk contains iron but prolonged breastfeeding can lead to iron deficiency if breast milk replaces solid foods in the diet. Low iron milks such as cows milk, goats milk and soymilk should not be given until 12 months of age. Children who drink milk in preference to eating solid foods are in danger of iron deficiency.
* Teenagers – adolescent girls are at risk because of a number of factors including growth spurts at puberty, iron loss through periods (menstruation) and risk of undernutrition due to fad dieting that restricts the eating of a healthy range of foods.
* In general – gastrointestinal disorders, such as coeliac disease, are a rare but possible cause of anaemia in children.

Suggestions for parents – babies
To prevent iron deficiency in babies less than 12 months of age:

* Include an iron-rich diet during pregnancy. Red meat is the best source of iron.
* Tests to check for anaemia should be conducted during pregnancy. If your doctor prescribes iron supplements, take them only according to instructions.
* Breastfeed your baby or choose iron-fortified infant formulas.
* Don’t give your baby cows milk or other fluids that may displace iron-rich solid foods before 12 months of age.
* Don’t delay the introduction of solid foods. Start giving your baby pureed foods when they are around six months of age. Fortified baby cereal made with iron-fortified infant formula or breast milk is generally the first food to offer. This is because of its iron content but also because its texture is easy to change. Introduce finely minced meat at one mealtime at around eight months.

Suggestions for parents – young children
To prevent iron deficiency in toddlers and preschoolers:

* Include meat, poultry and fish. These are important sources of iron in your child’s daily diet. If your family follows a vegan or vegetarian diet, you may need to seek advice from a dietitian to ensure you are meeting all your child’s dietary needs.
* Include vitamin C as this helps the body to absorb more iron. Make sure your child has plenty of fruits and vegetables.
* Encourage solid foods at mealtimes and take care that toddlers are not ‘filling up’ on drinks between meals.
* Chronic diarrhoea can deplete your child’s iron stores, while intestinal parasites such as worms can cause iron deficiency. See your doctor for prompt diagnosis and treatment.
* Fussy eaters may be at risk due to poor intake or lack of variety in the foods they eat. Seek advice from your dietitian, local doctor or child health nurse on how to manage a fussy eater, or browse the Better Health Channel site for more information.

Suggestions for parents – teenagers
To prevent iron deficiency in teenagers:

* Talk to your child about the importance of iron. Help them become informed enough to make their own responsible food choices.
* Encourage iron-rich foods and meals, such as iron-fortified breakfast cereals and breads, and serve meat, poultry or fish with the evening meal.
* Offer good sources of non-haem iron such as peas, broccoli, spinach, beans, fortified cereals and breads if your child wants to avoid red meat or become vegetarian. Vitamin C rich foods should also be encouraged, such as fruits or vegetables with meals.
* Encourage only moderate amounts of tea and coffee, as these can interfere with iron absorption.

Practical ways to increase iron in the diet for young children

* Include red meat three to four times per week.
* Offer meat alternatives including dried beans, lentils, chickpeas, canned beans, fish, eggs and small amounts of nuts and nut pastes.
* Include foods rich in vitamin C like oranges, mandarins, berries and tomatoes.
* Encourage young children, toddlers or fussy eaters to try minced meats, fortified breakfast cereals, eggs and smooth nut pastes.

Diagnosis
It is important that you see your doctor if you suspect that your child may be iron deficient. Diagnosis aims to exclude other illnesses that can have similar symptoms, such as coeliac disease. Diagnosis methods include:

* Physical examination
* Medical history
* Blood tests.

Treatment
Treatment may include:

* Dietary changes, such as increasing the amount of iron-rich foods
* Iron supplements (tablets or liquid for infants/young children) – under medical supervision only
* Treatment for infection, as infection is sometimes the cause of mild anaemia in children.

Where to get help

* Your doctor
* An accredited practising dietitian, contact the Dietitians Association of Australia.
* Maternal and Child Health Line, Victoria (24 hours) Tel. 13 22 29
* Royal Children’s Hospital Tel. (03) 9345 5522
* Poisons Information Centre Tel. 13 11 26 (24 hours, 7 days)

Things to remember

* Babies, toddlers, preschoolers and teenagers are at risk of developing iron deficiency, mainly because their increased needs for iron may not be met if their diets are inadequate.
* If you are following a vegetarian or vegan diet, extra care needs to be taken to ensure you are getting enough iron in your diet.
* Keep iron supplements away from children – overdoses can be fatal in young children and infants.

iron deficiency

Iron deficiency is regrettably a common mineral deficiency of early childhood. Symptoms include poor appetite, weight loss, irritability, increased susceptibility to infections, and finally, anemia and pale appearance. Since the first four symptoms are rather nonspecific and common to many kids in the 15-18 month age range anyway, the diagnosis is often missed early on. Anemia doesn’t occur until the total body store of iron is quite low, since carrying oxygen to the tissues is the top priority of all. It is now thought that the more severe cases of iron deficiency may suffer permanent brain injury with loss of ultimate IQ points, so this is not a trivial issue.

Iron deficiency is unusual in full term first born children , in breast fed infants especially if supplemented with iron, or in children fed iron-fortified formula. Children at risk are thus premature babies, bottle fed infants on low or no iron formulas or (heaven forfend) whole cow milk in early infancy (or later on if the intake of cow milk is excessive – see milk baby).

A woman has quite a number of years to store up iron in her bone marrow before having her first child. During the third trimester, the fetus loads up iron stores from the mother’s supply. Thus iron deficiency is unusual in term first borns because mother’s iron stores are generally adequate for the first pregnancy. For the same reason, premature babies are routinely supplemented with iron.

However, early resumption of menstruation (and sometimes mother’s reluctance to stay on her iron supplement) may lead to a situation of relative iron deficiency in the mother by the time of the next conception. Thus the second or third born child is at a somewhat higher risk for iron deficiency.

The type of milk in the child’s diet is important as regards the child’s iron status, too. Cow milk binds iron tightly to itself and most of the iron, even in iron fortified formula, is bound to stool protein residues that aren’t absorbed. Thus another risk factor stems from the persistent mythology about iron in infant formulas. Every ill conceivable in babies gets blamed on the iron in the formula at one time or another. Of course, this is mythology and nothing more. There have been numerous scientific studies that have proven that the tiny amount of iron in infant formula (1.8 milligrams per 5 ounces of formula) produces absolutely no symptoms in the babies whatsoever except health. It is highly inadvisable to feed your baby low iron or iron free formula. I personally would consider suspect the judgement of a physician who recommended prolonged feeding of iron-poor formula or who advised whole cow milk to young infants. Fortunately, iron poor formulas are being withdrawn from the US market, and not a minute too soon.

Breast fed babies are lucky. Whereas the majority of a bottle fed baby’s iron intake winds up in the diaper because it isn’t absorbed, mother’s milk contains a special protein, lactoferrin, which binds up whatever iron is in the breast milk and transfers it into the baby’s system with minimal loss in the stool.

Note as well that iron deficiency does not occur solely in infancy. Older children can suffer its effects as well. Recent research1 has identified the possibility of lower academic function in iron deficient school age children, especially adolescent girls.

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1. Health Online
   14 Temmuz 2011
   

   Now its very easy to contact with doctor .

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