What is iron?
Iron is a mineral everyone needs to keep their body working at its best. Iron works by forming hemoglobin, which is an important part of red blood cells. Hemoglobin carries oxygen to all parts of the body.
When the body does not have enough iron, a child can develop iron-deficiency anemia. This means the body cells get less oxygen. This causes the child to look pale and feel tired, weak and irritable.
Signs and symptoms of iron deficiency include:
- fatigue
- weakness
- pale skin
- shortness of breath
- headache, especially with activity
- dizziness
- cold hands and feet
- poor appetite
- craving for ice or clay
What causes iron-deficiency anemia?
To be healthy, growing children need a constant supply of iron, otherwise their iron stores become low. Iron deficiency can occur in babies and children if they have a diet low in iron-containing foods, or if their bodies have trouble absorbing iron.
Possible causes of iron deficiency are:
- Drinking a lot of milk (more than 20 ounces, or 600 mL, per day) or juice (more than 4 ounces, or 120 mL, per day) every day. Children fill up with these low-iron fluids and do not get the amount of iron that their body needs.
- Drinking from a bottle after two years of age. These children are at a higher risk of iron-deficiency anemia than those who stop bottle-feeding earlier.
- Eating a diet poor in iron-containing foods.
- Slow, chronic blood loss within the body.
Which foods are high in iron?
Iron is found in many animal and plant food sources.
- Iron from animal sources is called heme iron. Our bodies can absorb heme iron better than non-heme iron.
- Iron from plant sources is called non-heme iron. Our bodies can absorb non-heme iron when we eat it with foods that contain vitamin C (such as orange juice, citrus fruit, broccoli, strawberries, green or red peppers or tomato sauce) or when we eat it with sources of heme iron.
The following table lists examples of heme iron foods and non-heme iron foods.
| Heme iron foods (easy to absorb) | Non-heme iron foods (harder to absorb) |
|---|---|
Beef (hamburger, beef liver, corned beef, steak) Lamb Chicken (breast, thigh, chicken wings, chicken liver) Turkey (dark meat has more iron) Veal Pork Fish (haddock, halibut, salmon, tuna), canned in water Sausages Clams or oysters | Iron-fortified formula and iron-fortified infant cereal Cream of wheat Oatmeal Iron-enriched breakfast cereals (Cheerios, corn flakes) Beans: chick peas, lima beans, navy beans, kidney beans, lentils Baked beans (canned) Baked potato with skin Dried fruit: dried apricots, dried figs, raisins Prune juice Pasta, enriched Rice, enriched Tofu, firm Molasses, blackstrap Broccoli Spinach |
Getting enough iron at different ages
Babies
Breast milk contains enough iron to prevent anemia for the first four to six months of life. After this, babies need other sources of iron in their diet, such as iron-fortified cereal or meat.
If you choose to bottle-feed, use an iron-fortified formula until your baby is at least one year of age. Do not use "low iron" formulas. These formulas do not contain enough iron to meet your growing baby's needs.
To make sure your baby is getting enough iron, babies who are exclusively breastfed or formula fed until four to six months of age can be offered meat or iron-fortified cereal as a first food. You can also offer medium or firm tofu, peas, lentils and beans.
Children and toddlers
Children and toddlers who drink a lot of milk or juice are at risk for iron-deficiency anemia. To help children over two years of age get enough iron, you should:
- Remove all bottles and offer milk from a cup.
- Limit milk intake to 2 cups (16 ounces, or 450 mL) every day.
- Offer iron-containing foods every day.
How is iron deficiency treated?
Oral iron supplements (ferrous fumarate or ferrous sulfate) are required to treat iron-deficiency anemia. Supplements should be taken as prescribed by your doctor. Iron supplements are absorbed best when taken with a source of vitamin C, or on an empty stomach. They are absorbed poorly if taken with meals. Iron supplements should not be taken with milk or dairy products.
Please speak to your doctor, dietitian, or pharmacist for more information about taking iron supplements.
Preventing iron deficiency: Tips to increase iron intake
Providing children with foods high in iron can increase iron stores and prevent iron deficiency from occurring.
- Limit cow’s milk to 2 cups (16 ounces, or 500 mL) per day.
- Limit juice to 1/2 to 1 cup (4 to 8 ounces, or 120 to 240 mL) per day.
- Serve beef, pork, lamb, chicken, dark turkey meat, organ, beans or legumes every day.
- Select cereal, bread, rice, and pasta with the words "enriched" or "fortified" on the label.
You can also try:
- Serving citrus fruit (orange, grapefruit, tomato) with iron containing foods to increase absorption: for example, hamburgers with orange juice to drink, orange wedges with meat, chicken with broccoli, or spaghetti and meatballs with tomato sauce.
- Adding dried peas or beans to soups and casseroles.
- Using liquid from canned peas and beans for gravies, soups, and stews.
- Serving liver pate or sardines on whole-wheat crackers or toast.
- Sprinkling dried fruit (dates, raisins, prunes, apricots) on cereal.
- Adding raisins to lunches, favourite desserts, and hot cereal.
- Using oats, whole-wheat flour, and bran when baking.
- Adding blackstrap molasses to muffins, baked beans, gingerbread, and cereals.
- Adding beef to tomato or pasta sauce.
- Adding chunks of ham to macaroni and cheese.
- Serving baked beans with pork and tomato sauce.
- Using kidney, lima, or navy beans with cooking.
- Using whole-wheat or enriched breads and cereals.
- Serving cream of wheat or oatmeal for a snack.
- Offering water for thirst in between meals and snacks.
See your doctor if you notice that your child becomes pale or tired.