iron deficiency

75% of infants and 25% of toddlers in Australia have an iron deficiency. How can you spot it?

Approximately 75% of infants aged six to 12 months and 25% of toddlers aged one to two years in Australia do not meet the recommended dietary iron intake. Despite their tiny bodies, weaning babies and children require similar amounts of iron to adults. Iron plays a critical role in supporting rapid growth in blood and muscles, bolstering immunity, aiding brain development, and facilitating learning.

Untreated iron deficiency can progress to anemia, a severe condition characterised by insufficient healthy red blood cells to transport oxygen effectively throughout the body. Anemia actually affects approximately 8% of Australian children under the age of five.

How can you identify iron deficiency in kids?

Iron deficiency in infants and toddlers tends to be predominantly a nutritional disorder (insufficient iron-rich foods or excessive cow milk consumption) and is rarely due to malabsorption or gastrointestinal bleeding. 

Identifying it can be tricky for parents as iron deficiency in children often presents with vague or no symptoms, especially if it has not progressed to anemia. Signs may include fatigue, difficulty concentrating, poor behavior, frequent infections, and pica (consumption of non-food substances like paper, clay, or soil). Diagnosis of the deficiency typically involves a blood test screening.

Risk factors for iron deficiency include:



  • Maternal iron deficiency 

  • Prematurity and/or low birth weight 

  • Multiple pregnancy (twins)

  • Exclusive breastfeeding after 6 months 

  • Late or insufficient introduction of iron-rich solids

  • Excessive cow milk consumption

  • Vegetarian or vegan diet

  • Gastrointestinal disorders eg Meckel diverticulum, coeliac disease, inflammatory bowel disease, gastric or intestinal surgery or infection 

  • Other chronic blood loss


What are the treatment options for iron deficiency? 

When iron deficiency is a nutritional disorder, dietary changes and oral iron supplements are typically effective treatment options. The Royal Children’s Hospital in Melbourne advises increasing the consumption of iron-rich foods such as meat, fish, eggs, leafy greens, and legumes while limiting cow’s milk intake to less than 500mL (about two cups) per day. 

Cow’s milk has been linked to reduced iron stores in young children. Doctors may also prescribe oral iron supplements, usually in liquid or tablet form for a minimum of three months. Follow-up blood tests monitor the child’s response to supplementation.

Research suggests that supplements are more effective at replenishing iron stores than dietary changes alone, with ferrous sulfate being the most effective supplement for young children.

Are there any side effects to watch out for?

Iron supplements can have side effects including constipation, nausea, diarrhea, dark stools, and stained teeth, which can pose challenges, especially for young children. Doctors may recommend alternative supplements that are better tolerated. Adjusting the dosage, opting for lower doses or taking supplements, can also help alleviate side effects. 

As a compounding pharmacy, we can custom-make iron supplements for children in lower doses or more concentrated doses in alternative forms (e.g. flavoured liquids) if required. Our expert compounding pharmacists Jenny and Michelle are available to chat at (03) 9509 7912 or in person at 153 Burke Rd, Glen Iris, VIC 3146.

In cases where iron supplements are ineffective or compliance is an issue, doctors may prescribe iron infusions, which involve injecting iron over multiple hospital or clinic visits, each lasting about an hour or more.

Prevention matters!

It goes without saying, it’s important to monitor your child’s iron intake and factors that influence absorption. Drinks containing tannins, like tea, coffee, and chocolate drinks, may inhibit iron absorption. 

Conversely, vitamin C and organic acids from fruits and vegetables, along with high-quality proteins found in meat and fish, can promote absorption.

Following national feeding guidelines from infancy is crucial. Introduce iron-rich solid foods around six months of age for healthy breastfed infants to replenish their iron stores. This is also a suitable time to introduce foods that minimise the risk of food allergies, including iron-rich foods like seafood and nut butters.

From 12 months onward, align your child’s diet with the Australian Dietary Guidelines, emphasising a balanced, nutritious diet with a variety of foods. Such diets should provide ample iron from meats, bread, cereals, as well as iron absorption-promoting foods like oranges, capsicum, and fresh fruits and vegetables.

Iron-rich food sources for kids:

Image source

For picky eaters or in cases of limited food diversity, consider fortified iron options available in products like bread, juice (for kids over 12 months), and breakfast cereals.

If your child is diagnosed with iron deficiency, consult with a practitioner or dietitian to tailor solutions to their specific needs on their path to recovery.

Opinions or facts expressed within the content have been sourced from various news sources. While every effort has been taken to source them accurately, the pharmacy, its owners, staff or other affiliates do not take any responsibility for errors in these sources. This article does not constitute individual health advice. Patients should not rely on the facts or opinions in the content to manage their own health, and should seek the advice of an appropriate medical professional. Further, the opinions or facts in the content do not reflect the opinions and beliefs of the pharmacy, its owners, staff or other affiliates.

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