This simple check can help you figure out if your child has low iron. Gently pull down their lower eyelid and check the colour of the inside of the eyelid.  If the colour is pale pink or whitish looking your child could be low in iron. The image attached is after 90 days of supplementation for low iron levels.


Common Symptoms of Low Iron in Children

• Behavioural issues
• Dark circles under the eyes
• Slow growth
• More colds and flu
• Loss of appetite
• Pale skin
• Pale inside lower eyelids
• Pale fingernails
• Irritability
• Eating strange substances like ice or dirt (Pica)


Kids Need Iron

Iron is essential for growth and development in children.  Most of the discussions about iron focus on  women due to the blood loss from menstruation. Many women have very heavy periods that can greatly diminish iron stores. The World Health Organization states that approximately every second pregnant woman in the developing world is anemic.  Doctors, midwives and other health care professionals encourage women to take a supplement with iron but there is not much discussion about kids and iron.

Taking an iron supplement while pregnant and breastfeeding helps ensure the developing fetus and breastfeeding infant get adequate iron. Infant formulas and baby cereals are also fortified with iron to ensure infants are receiving enough iron from food.  Around 6 months after giving birth iron stores in breast milk start to decline.  This is naturally offset by the fact that this is also when most babies start eating some solid foods (hopefully containing iron). But getting iron into a baby, toddler or school-aged child can be challenging.  Even though most infant cereals are fortified with iron many babies do not like the taste or texture. Your toddler may be very picky and be going through the white pasta with white sauce phase that all parents worry about. For some children the picky food stage can last far into the elementary years.

The problem is if you aren’t looking you do not see iron deficiency in children until it becomes a health concern. Iron deficiency is not a gaping wound or a digestive issue.  And when you finally realize your child is low in iron it may take some work to get those iron levels back up.

The Role of Iron in the Body

Iron plays a major role in energy production. Low iron means less oxygen is delivered to your cells. Iron is part of hemoglobin, a protein in red blood cells that carries oxygen into the body’s tissues. Oxygenated blood is a dark, rich red colour. Every day your body uses hemoglobin which is your readily available iron, and that iron is drawn from your stored iron, ferritin. If we do not eat enough iron containing foods and fill up our ferritin stores then our daily supply of iron will slowly drop leading to many health conditions associated with low iron levels.


Raising Low Iron Through Diet

To combat iron deficiency, ensure your child eats a healthy and balanced diet. Now this is easier said than done. I laugh because if I was able to put all the foods my two girls like to eat into one diet it would be perfectly balanced but because they each like completely different foods it is not the case. One is a self-proclaimed vegetarian who can spot the hidden meat in any meal and I have to persuade, bribe and trick my carnivore who only eats the occasional vegetable.

There are two types of iron in food: heme and non-heme. Heme is found in flesh food (meat) and are easily absorbed. Non-heme iron is found in plant sources which the body has a hard time absorbing.

Foods high in Iron
• Beef
• Poultry (chicken, turkey)
• Seafood
• Eggs
• Nuts
• Beans and lentils
• Dark green leafy vegetables
• watermelons

Vitamin C aids iron absorption so encourage your children to eat the following foods high in vitamin C.

Foods high in vitamin C
• green and red peppers
• kale
• broccoli, Brussel sprouts and cauliflower
• strawberries
• pineapples
• Mangos
• Kiwis


Iron Supplements for Children

Adding a nutritional supplement with iron may be the best option for the picky eater.  Health Canada has a recommended daily amount of 11 mg of iron per day for children under one years of age.  Seven milligrams for ages one to three years of age and 10mg per day for children up to 8 years old. Many children’s multivitamin and mineral supplements contain iron at this level which should be sufficient for most children. For children who already have low levels of iron they would need to take more than what you would find in a common children’s multivitamin with minerals and how much more is determined by your health care practitioner.

When looking for an iron supplement go for liposomal iron. Liposomal iron is unique as each molecule of iron is surrounded by a bubble.  The liposome allows the iron to be readily absorbed with no constipation or stomach upset.  Liposomal iron also increases ferritin and hemoglobin quickly.


You think your child may have low iron … Next step

If you think your child may have low iron levels or iron deficiency anemia make an appointment with your family doctor or health care provider.  In the meantime, make a food diary of what your child is eating. Sometimes all it takes is for us to write something down and see it on paper to realize they just are not or cannot get what they need from their current diet.

Once at your appointment, talk to your doctor, pediatrician or health care practitioner to see if your child may have low iron levels. They may need a blood test to see ferritin and hemoglobin levels which would tell if they needed additional supplementation above the standard recommended daily amounts. This amount is calculated by the doctor and normally checked at 3 months to see if there has been an improvement. You should start to see the symptoms of low iron levels gradually fade away. This can be a long process since you have to build it back up while using iron daily. If you have suspect that your child is anemic or has low iron levels make an appointment now to get tested. A simple change in diet or supplementation could make a world of difference.