Iron is a very important nutrient that is required for the healthy growth of children. Now, healthy red blood cells require iron to form hemoglobin, which carries oxygen from the lungs to all the tissues and organs in the body. Now, depletion of iron will reduce the formation of hemoglobin causing Iron deficiency anemia, which will impede adequate oxygenation of the tissues leading to disruption of the normal physical and mental growth. Now, iron deficiency is caused by – eating a diet poor in iron, blood loss from the gastrointestinal tract from conditions like ulcers, polyps, a cow’s milk protein allergy and unable to absorb iron as you would see in an inflammatory bowel disease.
Risk factors
The children at risk of developing iron deficiency anemia include – premature or low birth weight infants, babies who are not started on complimentary feeds by age of 6months, babies who are not breastfed and are on a formula which is not enriched with iron, children who are introduced to cow’s milk before 1 year of age, toddlers who drink more than 2 or 3 cups of milk in a day, children with any form of chronic illness and adolescent girls during the time of puberty if they are not consuming an iron rich diet, fall at the risk of developing iron deficiency anemia.
Symptoms
Symptoms include – pale skin and pale mucus membrane, fatigue which is a feeling of tiredness, shortness of breath – especially while climbing stairs and dizziness may be present. There can be palpitations, where the patient is aware of the heart pounding. There can be poor appetite, slowed growth with some behavioral problems, increased incidences of infections and you can see craving to eat some non-edible substances such as paint, chalk, dirt, mud etc. This called as pica.

Diagnosis
In terms of diagnosis, your doctor may get a detailed diet history of your family and of the child. A thorough physical exam will be performed which may reveal pale mucus membranes, pale nail beds with brittle nails, smooth tongue, fissures at mouth corners, an enlarged spleen and an abnormal heart rhythm or murmur. Now, your child will require a blood test to check the level of hemoglobin and iron stores. A stool test maybe performed to look for any microscopic blood loss from the gastrointestinal tract.

Treatment
In terms of treatment, your doctor may prescribe some iron supplement pills or a syrup which is best taken on an empty stomach and with some citrus juice that is rich in vitamin C which helps with iron absorption. Now, you need to feed your child iron rich foods which include – egg yolks, lean red meats like lamb, seafood like tuna, salmon, shrimp and liver. Iron-fortified breads and cereals, peas, lentils like white and red kidney beans – that is your rajma, soybeans and chickpeas – which is your channa, dried fruits such as dates, raisins, and prunes, even nuts are a good source of iron. Spinach and other dark green leafy vegetables and tofu also serve as good sources of iron.

Prevention
What can we do to prevent this iron-deficiency anemia? Firstly, breast feed babies until 1 year of age or use iron fortified milk formula and do not introduce cow’s milk before 1 year as it is low in iron. Start complimentary feeding by age 6 months with iron fortified cereals or homemade iron rich foods. Ideally, it is recommended to do a blood test to look for any iron deficiency in babies between 9-12 months of age. Encourage children to have a balanced diet that is rich in iron and vitamin C. Ensure your kids have no more than 2 cups of milk a day. Keep your well child visits with your doctor allowing to screen regularly for iron deficiency and for the growth and development.

Team Ovum Hospitals