Iron Deficiency Anemia In Toddlers

5 min read

By Dr. Stalin Ramprakash, MBBS, MD, MRCPCH, CCT, FRCPCH
Consultant - Paediatric Haematology, Oncology and BMT, Aster CMI Hospital
21 years of experience

As such, toddlers are amazing just being themselves. Some days they will refuse to eat a painstakingly prepared meal and on others they lick mud. In spite of this, parents need to be careful that they are getting enough iron in their diet as it is required for proper growth and development. Why, when and how much iron do these little balls of energy need? How can we ensure that they are getting enough iron? Is not getting enough iron a threat to my toddler? These are some of the questions that parents usually ask to know more on anemia in toddlers.

Iron Deficiency Anemia In Toddlers

Why do Toddlers Require Iron?

Iron is a very important mineral as it is a key part of hemoglobin, a protein in our blood that carries oxygen from the lungs around the body and so plays a vital role in the functioning of the brain and muscles. Toddlers who are extremely iron deficient or anemic can have behavioral or developmental problems like delays in growth both in physical and mental terms. Some studies suggest that persistent anemia in toddlerhood may have permanent impact on IQ scores in adult life.

How Much Iron Does a Growing Toddler Needs?

The recommended amount of daily iron is 11 mg for infants from 7 months to 1 year and 7 mg for toddlers from 1 to 3 years. During birth, babies are born with iron that is stored in their bodies. However, to continue growth and development at a steady pace, toddlers need additional iron which must be supplied to them through their diet.

What are the Symptoms of Anemia in Toddlers?

While anemia in toddlers does not have many symptoms, following need be observed:

  • Mild cases can be spotted when your toddler is easily tired or unable to focus or listless or irritable.
  • Moderate and more severe cases can result in pale, out-of-breath toddler who may catch infection very easily. To confirm it, a blood test would be required.
  • Symptoms for more severe cases also include difficulties maintaining body temperature and pica, unusual cravings for dirt, chalk, ice, etc.

Is My Toddler at a Risk of Iron Deficiency?

toddler risk of anemia

Infants and toddlers can be at risk of developing iron deficiency due to:

  • Premature or low birth weight.
  • Breastfed babies aren’t given additional iron-rich foods after six months. After a toddler attains the age of 6 months, the diet needs to be supplemented with other foods than just breastmilk which we call as weaning.
  • Formula-fed babies are not being given iron-fortified formula.
  • Babies drinking cow’s milk before 1 year of age.
  • Infants and toddlers prone to infection or on restricted diets or those who have lead exposure.

Combating Iron Deficiency in Toddlers and Small Children

food rich in iron -dried fruits

While iron supplements seem an easy solution, it is not recommended to give them to infants or toddlers unless prescribed by a doctor. However, a few simple dietary changes can ensure your toddler is receiving adequate iron.

In cases of extreme deficiency, drops might be prescribed. In these cases, it can take up to two months for the iron levels to return to normal and another half to one year to build up iron stores, maintained by a healthy diet.

Breastfed babies post the age of 6 months should be given additional iron-fortified cereals and other food that can help fight iron deficiency. An iron-rich diet can be maintained by providing food that are good sources of iron:

  • Meat – lean red such as lamb, dark chicken meat from thighs or legs or liver (not more than once a week)
  • Oily fish such as mackerel (bangda), tuna or salmon (raw)
  • Green vegetables especially the leafy kind
  • Eggs
  • Grains like ragi ( red millet), dals, rajma (kidney beans), lobia (black-eyed beans)
  • Dried fruits like raisins (kishmish), dried apricots, dried figs, prunes, dates
  • Nuts ( care should be taken while given to infants and toddlers to prevent choking)
  • Iron-fortified food such as some types of bread, breakfast cereals, biscuits, and other snacks
  • Wheatgrass
  • Fruits such as pomegranate

Apart from this, foods can be given to ensure the healthy absorption of iron. This is done by giving food rich in Vitamin C :

  • Fruits such as citrus fruits, strawberries, kiwi fruit, papaya or pineapple
  • Vegetables such as capsicum, broccoli, peas or cauliflower
  • Diluted fruit juices especially citrus ones

Can I Give Cow’s Milk To My Baby?

Cow’s milk is not recommended for babies less than a year old. Cow’s milk does not contain enough iron to fuel a toddler’s growth and too much cow’s milk is a strict no. Milk also makes it harder for the body to absorb iron thus paving the way for iron deficiency anemia in toddlers.

Care should also be taken to ensure too much milk or calcium-rich foods such as cheese, paneer, curd,  some vegetables and nuts like almonds are not given during and in between meals as calcium hinders the absorption of iron.

A toddler only requires around 350 – 500 ml of milk in one day. With too much milk they toddlers may look chubby but they will be iron deficient and have unhealthy weight.

How Can I Prevent Iron Deficiency in My Toddler?

toddler eating healthy food to prevent anemia

Iron deficiency in toddlers can be completely avoided with a little care and attention to what they are eating. While ensuring your toddler has enough iron in their diet is a must, there is no need to panic if they refuse to eat iron-rich food one day and wolf it down the next. The body stores iron and has enough supplies to fill in the gaps.

Encouraging the toddler to eat a wide variety of food substances is far better than having very restricted choices. Establishing the variety is best achieved between 6-12 months after food refusal may become a problem.

The rule of thumb here is to ensure your toddler gets a well-balanced and nutritious diet covering all food groups over a week, monitor their growth and development and approach the doctor in case of any concern.

Read Also: Top Delicious Foods For Picky Toddlers

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Dr. Stalin Ramprakash, MBBS, MD, MRCPCH, CCT, FRCPCH
Consultant - Paediatric Haematology, Oncology and BMT, Aster CMI Hospital
21 years of experience

Dr. Stalin Ramprakash is an experienced and dynamic consultant who provides high-quality comprehensive care for children with cancer and blood-related problems. He completed his paediatric training in Madras Medical College and pursued further training in the United KingdomRead more.

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