What Is Iron-Deficiency Anemia?

Iron-deficiency anemia is anemia that happens when there isn't enough iron in the body.

Someone with anemia has a lower number of red blood cells (RBCs) than usual. RBCs contain hemoglobin, a protein that carries oxygen throughout the body. The body needs iron to make hemoglobin (HEE-muh-glow-bin). Without enough iron, less hemoglobin and fewer red blood cells are made, leading to anemia.

Treatment with iron supplements usually makes the anemia better.

What Are the Signs & Symptoms of Iron-Deficiency Anemia?

At first, children with iron-deficiency anemia may not have any symptoms. When symptoms do happen, a child might:

• look pale
• seem moody
• be very tired
• get tired quickly from exercise
• feel dizzy or lightheaded
• have a fast heartbeat
• have developmental delays and behavioral problems
• want to eat ice or non-food items (called pica)

What Causes Iron-Deficiency Anemia?

Iron-deficiency anemia can happen when:

• There's a problem with how the body absorbs iron (such as in celiac disease).
• Someone has blood loss from an injury, heavy menstrual periods, or bleeding inside the intestines.
• Someone doesn't get enough iron in the diet. This can happen in:
  • children who drink too much cow's milk, and babies given cow's milk before they're 1 year old
  • vegetarians because they don't eat meat, a source of iron
  • breastfed babies who don't get iron supplements
  • babies given formula with low iron
  • babies who were born early or small who may need more iron than formula or breast milk contains

How Is Iron-Deficiency Anemia Diagnosed?

Doctors usually can diagnose iron-deficiency anemia by:

• asking questions about symptoms
• asking about the diet
• finding out about the patient's medical history
• doing a physical exam
• doing blood tests to:
  • look at the red blood cells with a microscope
  • check the amount of hemoglobin and iron in the blood
  • check how fast new RBCs are being made
  • do other blood tests to rule out other types of anemia

How Is Iron-Deficiency Anemia Treated?

Doctors treat iron-deficiency anemia with iron supplements taken as a liquid or pill for at least 3 months. To help iron get absorbed into the body:

• Avoid taking iron with antacids, milk, or tea because these interfere with the body's ability to absorb iron.
• Take iron before eating (unless this causes an upset stomach).

Someone whose anemia is very severe or who cannot take oral iron may get iron or a blood transfusion through an IV (intravenous) line.

When iron-deficiency anemia is caused by something other than a lack of iron in the diet, treatment also may include:

• treatments to reduce bleeding in heavy menstrual periods
• reducing the amount of cow's milk in the diet
• treating an underlying disease

How Can Parents Help?

If your child has iron-deficiency anemia:

• Make sure your child takes the iron supplements exactly as prescribed.
• Include iron-rich foods in the family's diet. Good sources of iron include:
  • iron-fortified cereals
  • lean meat, poultry, and fish
  • tofu
  • egg yolks
  • beans
  • raisins
• Serve fruits and vegetables high in vitamin C or a glass of orange juice at mealtimes. This helps the iron get absorbed.
• Talk to a dietitian or your doctor if you need extra help getting more iron in your child’s diet or if your child is a vegetarian. They can recommend foods to help your child get enough iron.

To help prevent iron-deficiency anemia in young children:

• Don't give cow's milk to babies under 1 year old.
• Limit cow's milk in kids over 1 year old to less than 2 cups of milk a day. Giving them more can make them feel full and lower the amount of iron-rich foods they eat.