Recognising Iron Deficiency Anaemia in Children: A Guide for Parents | with Angela Hywood

As a parent, ensuring your child’s health and happiness is a top priority. One condition that can significantly affect their energy levels, growth, and overall well-being is anaemia, and it often goes unnoticed. Why is that? Without a blood test, it can be difficult to detect—unless you’re aware of the signs and symptoms to watch.

This guide is here to help you spot the signs and symptoms of anaemia in children, understand what might be causing it, and know when it’s time to reach out for support.

Signs and symptoms of anaemia in children

The symptoms of anaemia can vary, but some common signs to watch out for include:

1. Fatigue and weakness: Children with anaemia might feel tired and weak, as their bodies aren't getting enough oxygen.
2. Pale skin: If your child looks unusually pale, especially in their face, the lining of the eyelids, or nails, it could be a sign of anaemia.
3. Dark circles under the eyes: Sometimes, anaemia can cause dark circles, making a child appear tired.
4. Shortness of breath: A lack of oxygen in the blood might make your child feel breathless, particularly during play or other physical activities.
5. Rapid heartbeat: The heart might beat faster to circulate more oxygen-rich blood.
6. Irritability or behavioural changes: Anaemia can affect your child’s mood and energy, leading to increased irritability.
7. Poor appetite: Some children might lose interest in eating, which can result in weight loss or poor growth.
8. Delayed growth and development: Chronic anaemia can interfere with your child’s growth and cognitive development.
9. Frequent infections: Anaemia can weaken the immune system, making your child more prone to infections.
10. Pica: An unusual craving for non-food items like dirt, ice, or paper could indicate iron deficiency anaemia.

Fussy eaters and low iron

If you have a fussy eater, they might be at a higher risk of iron deficiency anaemia. Picky eating habits can limit the variety and balance of nutrients in their diet, making it tough to meet their iron needs. Iron-rich foods like red meat, poultry, fish, beans, and green leafy vegetables are essential for maintaining healthy iron levels. If these foods aren’t part of your child’s diet, they may not be getting enough iron. As your child's iron levels improve, they'll become less fussy and picky eaters!

Here are some tips to help for fussy eaters

• Offer a variety of foods: Try introducing iron-rich foods in different forms and presentations to make them more appealing.
• Pair iron with vitamin C: Vitamin C helps with iron absorption. Pair iron-rich foods with vitamin C-rich foods like oranges, mandarins, strawberries, or capsicum.
• Consider iron supplements: If dietary changes aren't enough, we often recommend iron supplements.

Forms of iron

When it comes to addressing anaemia or boosting your child's iron intake, it's helpful to understand the different forms of iron available and how they can affect digestion.

1. Heme Iron: Found in animal products like meat, fish, and poultry, heme iron is more easily absorbed by the body. It’s a great option for improving iron levels efficiently.
2. Non-Heme Iron: Present in plant-based foods like beans, lentils, spinach, and fortified cereals, non-heme iron is not absorbed as readily as heme iron. However, it can still be effective, especially when paired with vitamin C-rich foods like oranges or capsicum to boost absorption.

Recommended Daily Intake (RDI) of iron and vitamin B12 for children and teens

Understanding the RDI of iron and vitamin B12 is crucial for ensuring your child gets the nutrients they need.

Here’s a quick guide:

Iron RDI

• Toddlers (1-3 years): 7 mg per day
• Children (4-8 years): 10 mg per day
• Children (9-13 years): 8 mg per day
• Teen Boys (14-18 years): 11 mg per day
• Teen Girls (14-18 years): 15 mg per day.

Vitamin B12 RDI

• Toddlers (1-3 years): 0.9 mcg per day
• Children (4-8 years): 1.2 mcg per day
• Children (9-13 years): 1.8 mcg per day
• Teens (14-18 years): 2.4 mcg per day.

High iron diet ideas for toddlers and children

To ensure your little ones get enough iron, consider adding these foods to their diet:

1. Lean meats: Small portions of lean meats like beef, turkey, or chicken are great sources of easily absorbed iron.
2. Legumes: Beans, lentils, and chickpeas are packed with iron. Try making homemade hummus or adding beans to soups and stews.
3. Dark leafy greens: Spinach, kale, and other dark leafy greens can be blended into smoothies, added to sauces, or mixed into casseroles.
4. Eggs: Eggs are an excellent source of iron. Serve them scrambled, boiled, or as part of a vegetable omelette.
5. Nuts and seeds: Try nut butters or sprinkle seeds like pumpkin or sesame over salads and yoghurt.
6. Dried fruits: Raisins, apricots, and prunes are a sweet treat and a good source of iron.
7. Fish: Tuna or salmon can be included in meals or served as snacks.
8. Liver (chicken liver pate). This nutrient-dense food is an exceptional source of iron, providing a significant amount of bioavailable iron per serving. It also contains other essential nutrients, including vitamin A, vitamin B12, and folate, which support overall health and well-being. Introducing small amounts of organic liver into your child's diet can be a powerful way to boost their iron levels naturally. We freeze cubes of chicken liver and grate into bolognese, pasta or smoothies. Another wholefoods idea is to introduce your kids to chicken liver pate, this works well on rice crackers or as a dip.

The link between anaemia and anxiety in children and teens

Recent research suggests a link between anaemia and anxiety in children and teens. Iron is crucial for brain development and neurotransmitter synthesis. A deficiency in iron can lead to neurological and psychological changes that might manifest as anxiety, depression, and attention deficits. Understanding the psychological impact of anaemia is essential! If your kids or teens are suffering from any mood changes, especially anxiety, please ask your GP to check iron levels!

Treatment and prevention

Treatment for anaemia depends on the underlying cause. For iron deficiency anaemia, a diet rich in iron and iron supplements may be recommended. Cross-check for coeliac disease and other malabsorption issues.

Preventing anaemia involves ensuring a balanced diet that includes an abundance of iron, vitamin B12, and folate.

Iron supplements for kids

When it comes to iron supplements, here's a look at the different types and how they work:

Types of iron amino acid chelates:

1. Iron glycinate: This form combines iron with glycine, an amino acid. It's well-tolerated and absorbed efficiently, making it a gentle option for those who experience digestive discomfort with other forms of iron. It's also less likely to cause constipation.
2. Iron bisglycinate: Similar to iron glycinate, this form binds iron to two glycine molecules. It has excellent bioavailability and is very well absorbed. The double binding helps protect iron from interaction with other dietary components that could inhibit absorption.
3. Iron citrate: This type of iron is combined with citric acid, which can enhance its absorption. Iron citrate is generally easy on the stomach and is a good option for those needing a more absorbable form of iron
4. Ferric pyrophosphate (FPP) This is a gentle Ferric pyrophosphate (FPP) is a water-soluble iron that transforms transferrin to ferritin, really boosting iron reserves! The great fact is, that it doesn't have the typical metallic iron taste, making it easy to administer to kids.

Our tried and tested clinic favourite for kids - Bioclinic Natural Iron is a tasty chewable 10mg iron. This is a gentle ferric pyrophosphate (FPP) which is a water-soluble iron that transforms transferrin to ferritin, really boosting iron reserves!

The role of lactoferrin in iron absorption:

Lactoferrin is a protein that plays a key role in iron absorption. It helps by binding to iron, which increases its solubility and availability in the intestines. This binding also helps transport iron across the intestinal wall into the bloodstream. Lactoferrin has the added benefit of having antimicrobial properties, which can support overall gut health. Including lactoferrin in iron supplements can further enhance the absorption of iron, making it a valuable addition for those needing extra support with their iron levels.

Our clinic favourite for kids is Medlab Immune-5 

Choosing the right form of iron makes a big difference in managing iron deficiency and supporting energy, brain function, appetite and immunity for your kids. If you're unsure which one is best for you or your child, it’s always a good idea to consult one of our naturopathic team for personalised advice.

And finally…

Being aware of the signs and symptoms of anaemia can make a significant difference in your child’s health. By taking proactive steps to address any concerns, you can ensure your child receives the necessary care and support for optimal growth and development. If you have any doubts or questions, don’t hesitate to contact us for guidance.

References

American Academy of Paediatrics (AAP). Anaemia in Children.
National Heart, Lung, and Blood Institute (NHLBI). What Is Anaemia?
Mayo Clinic. Vitamin Deficiency Anaemia.
National Organization for Rare Disorders (NORD). Sickle Cell Disease.
WebMD. Dark Circles Under Eyes in Children.

Cleveland Clinic. Pica: Symptoms, Causes, Treatment.
MedlinePlus. Iron-Deficiency Anaemia.
Healthline. [Pairing Iron and Vitamin C] (https://www.healthline.com/nut) 

To book an appointment for your personalised treatment plan  book a consult with Angela here.

Naturopath and Founder of Floralia Wellness & Apothecary, Angela Hywood, has been specialising in women’s health, hormones and fertility for over 25 years.