Iron is a mineral necessary for good health and body function. Every red blood cell in the body contains iron in its hemoglobin, the pigment that carries oxygen to the tissues of the lungs. But a lack of iron in the blood can lead to iron-deficiency anemia, which is a very common nutritional deficiency in children.
What is iron deficiency anemia?
The body needs iron to make hemoglobin. If not enough iron is available, the production of hemoglobin is limited, which affects the production of red blood cells. A decrease in the normal amount of hemoglobin and red cells in the bloodstream is known as anemia. Because red blood cells are needed to carry oxygen throughout the body, anemia causes cells and tissues to receive less oxygen, affecting their function.
Although iron deficiency has long been considered the leading cause of anemia in childhood, it has become much less common in the United States in the last 30 years, primarily due to the existence of fortified infant formulas and cereals. iron.
Iron deficiency anemia does not develop immediately. The person progresses through several stages of iron deficiency, beginning with a reduction of iron in the body, although the amount of iron in the red blood cells remains the same. If the iron depletion is not corrected, the next stage is iron deficiency, which eventually becomes iron deficiency anemia.
What is the cause?
Iron deficiency anemia can be caused by several factors, including:
- insufficient iron in the diet
- poor absorption of iron by the body
- ongoing blood loss, most commonly from menstruation, or a gradual loss of blood from the intestinal system
- rapid growth stages
A low iron diet frequently causes iron deficiency anemia in babies, children, and teens. Children who do not eat foods that contain iron, or who eat foods that contain little iron, are at risk of developing iron deficiency anemia. Poverty is also a contributing factor to iron deficiency anemia because families with low income or living below the poverty level may not eat foods rich in iron.
Iron deficiency can also contribute to increased lead absorption, increasing the risk of lead poisoning in children, especially those who live in older homes. The combination of iron deficiency anemia and lead poisoning can have serious health consequences for children and put them at risk for learning and behavior problems.
During childhood and adolescence, the body needs more iron. Children are at higher risk for iron deficiency anemia during these times of rapid growth because they may not eat foods that have enough iron during these times.
Babies who are discontinued from iron-fortified formula and fed cow's milk before 12 months of age are at risk for iron deficiency anemia. Cow's milk is low in the iron necessary for the growth and development of the baby and also frequently replaces the consumption of foods rich in iron. Milk decreases the absorption of iron and can irritate the intestines, causing small bleeds. The slow and gradual loss of blood through the stool - combined with poor iron intake and poor absorption of iron - can eventually result in this type of anemia.
Prematurity and low birth weight are also factors that put the baby at risk for iron deficiency anemia. Before birth, full-term, normal-weight babies have stored an amount of iron that can last 4 to 6 months. Since premature babies do not spend enough time in the womb feeding on the mother's diet, they do not store enough iron and are often depleted within 2 months.
Between the first year and 3 years of age, children are at risk for iron deficiency and iron deficiency anemia, although this is not an exceptional growth stage. Most children that age have already stopped eating iron-fortified formula and cereal and are not getting enough iron-rich foods. They also tend to drink a lot of cow's milk, often more than 24 ounces a day.
During the early stages of adolescence, when growth is very rapid, boys are at risk for iron deficiency anemia. Girls are also at risk because they are menstruating and store less iron than boys. Many girls also tend to eat a low iron diet.
نقص الحديد عند الاطفال
What are the signs and symptoms?
Many people with iron deficiency show no signs or symptoms because they gradually deplete stored iron. As anemia progresses, several of the following symptoms may be recognized:
- tiredness and weakness
- pale skin and mucous membranes
- rapid heartbeat and heart murmur (detected by your child's doctor during an exam)
- lack of appetite
- dizziness and dizziness
Rarely does the person with iron deficiency anemia suffer from pica, an insatiable desire to ingest inedible substances such as paint chips, chalk, or dirt. This condition can be caused by a lack of iron in the diet.
How is it diagnosed?
Iron deficiency anemia is usually found during a routine exam. Because symptoms, such as fatigue and loss of appetite, are common in other diseases, your child's doctor needs more information to make the diagnosis. The doctor who suspects iron deficiency anemia may ask you questions about your child's diet. You will also need a blood test that includes:
- The complete blood cell count (CBC) can reveal low levels of hemoglobin and hematocrit (the percentage of blood made up of red cells). The count also gives information about the size of the red blood cells. Red blood cells with a low hemoglobin level tend to be smaller and have less color.
- The reticulocyte count indicates the number of immature red cells that are being produced. This test is helpful because it indicates a problem exists before it turns into anemia.
- Serum iron measures the amount of iron in the blood; although it may not correctly indicate the iron concentration in the body's cells.
- Serum ferritin indicates total iron storage in the body. It is one of the first indicators of a deficiency in iron levels, especially when used in conjunction with other tests, such as the complete count.
The doctor may also examine your child's stools for blood, since iron deficiency anemia can be caused by small losses of blood from the gastrointestinal system. Since the blood is not visible, a stool sample is placed on special paper and a drop of a special solution is applied to it. A change in color indicates the presence of blood.
How is it treated?
Although most cases of iron deficiency anemia are the result of a low iron diet, dietary changes alone cannot replace depleted iron. Multivitamins with iron are also not suitable for children with iron deficiency anemia who have a low level of stored iron. These children need a daily iron supplement.
It is extremely important to remember that you should not give your child a strong iron supplement without first consulting your doctor. According to the American Academy of Pediatrics, excessive ingestion of iron is the leading cause of poisoning in children.
Iron is best absorbed when taken on an empty stomach; although it can cause stomach discomfort. Children who have stomach problems when taking iron supplements should take them with a small amount of food. Iron should not be taken with milk or beverages that contain caffeine as these interfere with its absorption. Vitamin C helps absorb iron and it is a good idea to include it in your child's diet.
After taking iron supplements for a month, your child's doctor may want to repeat blood tests to see if the hemoglobin and hematocrit levels have improved. If they have improved, your doctor will most likely recommend that you continue taking them for several more months. Once the problem is corrected, iron storage can be maintained through an iron-rich diet. At 6 months after iron therapy is completed, the doctor may want to repeat the hemoglobin test.
In rare cases, iron deficiency anemia is severe enough to require hospitalization. A blood transfusion is required when anemia is life-threatening.
Caring for your child
The effects of iron deficiency anemia depend on the duration and severity of the anemia. If left untreated, iron deficiency anemia can cause behavior or learning problems. These problems may not be reversed, even if an iron supplement is taken later.
In most cases, iron deficiency anemia can be prevented by following these recommendations:
- Babies under 1 year of age should only drink breast milk or infant formula with iron supplement. Breastfed babies should take an iron supplement.
- Children under 2 years of age should have no more than 24 ounces of cow's milk a day. As mentioned above, milk can prevent iron absorption and decrease the desire to eat iron-rich foods. In addition, excess cow's milk can also irritate the gastrointestinal system, causing intestinal bleeding - a cause of iron loss.
- Iron-fortified products like cereal are excellent sources of iron for children, especially those under 2 years of age.
- There are a wide variety of foods that can provide your family with good nutrition and iron: lean meats, eggs, green leafy vegetables, peas and beans, molasses, raisins, and whole grain bread.
- Make sure kids or teens on a vegetarian diet are getting enough iron. Because iron in meat is more easily absorbed than that of plants, you need to add iron-fortified foods to your diet.
Proper nutrition, including a diet rich in iron, is very important for all children. When good eating habits are established very early, it helps to avoid iron deficiency and therefore the consequent anemia.