Why is Iron Important in Children?

Why does our body need Iron?

Iron is an essential mineral that plays a key role in numerous vital bodily functions, especially during childhood when growth and development are at their peak. The most important roles of iron include:

1. Oxygen Transport: Iron is a core component of hemoglobin, a protein in red blood cells that carries oxygen from the lungs to the rest of the body. Adequate iron levels ensure that oxygen is efficiently transported to tissues and organs, promoting overall growth and development.
2. Brain Development: Iron is crucial for cognitive function and brain development. Iron deficiency, especially in early childhood, can impair cognitive abilities and affect learning, behavior, and emotional development.
3. Immune System Function: Iron supports the immune system by helping to maintain the health of the thymus, a gland responsible for producing immune cells. Low iron levels can reduce the body’s ability to fight infections.
4. Energy Production: Iron is required for the production of ATP (adenosine triphosphate), the molecule that provides energy for cells. Iron deficiency can result in fatigue, weakness, and reduced stamina.

What is Iron Deficiency?

Iron deficiency occurs when the body does not have enough iron to meet its needs. It is one of the most common nutritional deficiencies worldwide, particularly in children. Iron deficiency can lead to:

• Iron Deficiency Anemia: A condition where the body lacks enough healthy red blood cells due to insufficient iron, leading to symptoms like fatigue, pallor, irritability, and decreased appetite.
• Delayed Growth and Development: Iron deficiency can slow physical growth and impair motor development, making it harder for children to meet developmental milestones.
• Cognitive and Behavioral Issues: Iron deficiency, especially in infancy and early childhood, can result in long-term cognitive and behavioral problems, including difficulties with concentration and learning.
• Weakened Immunity: Children with low iron levels are more susceptible to infections due to a weakened immune system.

How Much Iron Does a Child Need?

The daily iron requirements for children vary by age, as follows:

• Infants 0-6 months: 0.27 mg (Adequate Intake, AI)
• Infants 7-12 months: 11 mg (Recommended Dietary Allowance, RDA)
• Children 1-3 years: 7 mg (RDA)
• Children 4-8 years: 10 mg (RDA)
• Children 9-13 years: 8 mg (RDA)
• Adolescent girls 14-18 years: 15 mg (RDA)
• Adolescent boys 14-18 years: 11 mg (RDA)

The amount of iron needed increases during periods of rapid growth, such as infancy and adolescence, as well as during menstruation in females.

What Causes Iron Deficiency in Children?

Several factors can contribute to iron deficiency in children:

Inadequate Dietary Intake

Insufficient iron-rich foods in the diet, especially in picky eaters or children with restrictive diets.

Poor Absorption of Iron

Some health conditions (e.g., celiac disease, inflammatory bowel disease) or medications can interfere with the absorption of iron from food.

Increased Iron Needs

Children going through periods of rapid growth, as well as those with higher physical activity levels, may require more iron.

Blood Loss

Conditions such as gastrointestinal bleeding or heavy menstrual periods in adolescents can deplete iron stores.

Exclusive Breastfeeding without Iron Supplementation

While breast milk is ideal for infants, it contains only small amounts of iron. Without iron-rich complementary foods after 6 months, iron deficiency can develop.

Good Sources of Iron in the Diet for Children

Iron comes in two forms: heme iron (found in animal products) and non-heme iron (found in plant-based foods). Heme iron is more easily absorbed by the body, but both types contribute to meeting daily iron needs. Here is a list of iron-rich foods for children:

Heme Iron Sources (Animal-Based)

• Red Meat: Beef, lamb, liver (especially beef liver, which is extremely high in iron)
• Fish & Shellfish: Sardines, salmon, tuna, haddock, oysters, and mussels
• Eggs: Particularly the yolk

Non-Heme Iron Sources (Plant-Based)

• Legumes: Lentils, chickpeas, beans (black beans, kidney beans, white beans)
• Tofu and Tempeh: Great plant-based protein sources that are rich in iron
• Fortified Cereal and Grains: Iron-fortified breakfast cereals, oats, quinoa, whole wheat bread, and pasta
• Dark Leafy Greens: Spinach, kale, collard greens, and Swiss chard
• Nuts and Seeds: Pumpkin seeds, sesame seeds, cashews, and almonds
• Dried Fruits: Apricots, raisins, prunes, and figs
• Sweet Potatoes: A good source of both iron and vitamin C
• Whole Grains: Brown rice, millet, barley, and bulgur wheat

Boosting Iron Absorption

Vitamin C helps the body absorb non-heme iron. To enhance absorption, pair iron-rich foods with vitamin C-rich foods such as:

• Citrus fruits (oranges, lemons, grapefruits)
• Strawberries, bell peppers, tomatoes, broccoli, and potatoes

Avoiding Inhibitors of Iron Absorption

Some foods and drinks can reduce the absorption of iron:

• Calcium: Found in dairy, calcium can compete with iron for absorption.
• Tannins: Found in tea and coffee, tannins can inhibit iron absorption.
• Phytates: Found in whole grains, legumes, and some seeds, phytates can reduce iron absorption. However, soaking and cooking these foods can minimize their effect.

Signs of Iron Deficiency in Children

Watch for these common signs and symptoms of iron deficiency or iron deficiency anemia:

• Unusual fatigue or weakness
• Pale skin and mucous membranes (such as inside the mouth)
• Irritability or mood changes
• Reduced appetite
• Slow weight gain or growth
• Difficulty concentrating, poor school performance
• Cold hands and feet
• Rapid heartbeat or shortness of breath during physical activity
• Craving for non-food substances (pica), (such as dirt or chalk)

How to Prevent Iron Deficiency

1. Provide Iron-Rich Foods: Ensure that your child’s diet includes a variety of iron-rich foods, with an emphasis on both heme and non-heme sources.
2. Fortified Foods: Consider incorporating iron-fortified cereals, breads, and pasta into your child’s diet, particularly for picky eaters.
3. Monitor Growth: Regular pediatric check-ups are crucial for monitoring growth, development, and any signs of nutritional deficiencies.
4. Iron Supplements: In some cases, such as during periods of rapid growth or for children at higher risk (e.g., premature infants, vegetarians), iron supplements may be necessary. Always consult your pediatrician before giving supplements.
5. Balanced Diet: Encourage a balanced diet that includes not just iron, but also other essential nutrients like protein, healthy fats, and vitamins that support overall growth and health.

Conclusion

Iron is an essential nutrient for the proper growth and development of children. Ensuring an adequate intake of iron-rich foods, being mindful of factors that enhance or inhibit iron absorption, and watching for signs of deficiency are key to maintaining optimal health. If you are concerned about your child’s iron levels, consult a pediatrician who can provide tailored guidance and, if necessary, testing for iron deficiency or anemia.

References:

• World Health Organization (WHO), Iron Deficiency Anemia: Assessment, Prevention, and Control (2001)
• American Academy of Pediatrics, Iron Deficiency Anemia in Children (2020)
• National Institutes of Health, Iron – Fact Sheet for Health Professionals (2020)