|: Iron Deficiency Can Affect Child Development
Dear DR. PAUL: My 18 month old son recently had
his blood drawn to check his iron count and it came back very
low. What exactly does iron deficiency do for children as far
as intelligence and development?
PEDIATRICIAN DR. PAUL Answers: Thanks for the very
timely question as there have been several recent reports on the
effect of iron deficiency anemia on both developing infants and
older children too. Before I go on further let me explain what
iron deficiency anemia means. Ordinarily, our red blood cells
contain a substance called hemoglobin. Iron is a key ingredient
in forming hemoglobin. If there is not enough iron in the body,
then an insufficient or lower amount of red blood cells are produced.
This is referred to as "iron deficiency anemia".
Up until about 20 years ago we thought that the only consequences
of iron deficiency were limited to physical symptoms such as pale
complexion and fatigue. During the early 1990's the medical community
became concerned when studies suggested that iron deficiency anemia
was linked to developmental delays. This effect was confirmed
by a more recent study. At about the same time, other studies
revealed a surprisingly high incidence of iron deficiency anemia
in babies/toddlers. Alarmingly, the developmental delays in some
severe cases, did not improve despite treatment with iron. Clearly
then, we must prevent iron deficiency anemia in the first place
by ensuring children eat enough iron-containing foods. Babies
are born with enough iron in their bodies for the first 4 to 6
months of life. After that period, extra iron in the diet is required.
One of the factors that is thought to contribute to anemia is
the early introduction of whole cow's milk in the diet; This is
why the Canadian Pediatric Society currently recommends avoiding
whole cow's milk for most of the first year of life. (The American
Academy of Pediartics recommends avoiding whole cow's milk for
the first 12 months of life)
In order to be able to use dietary iron, it must be able to be
absorbed into the body. For example, whole cow's milk contains
as much iron per liter as breast milk, but only a very small proportion
is actually absorbed into the body. However, the iron in breast
milk, is very well absorbed by babies. For this reason, breast
milk is one of the best sources of iron for baby providing all
the iron needed(along with all other nutrients and benefits) for
the first 6 months of life. Bottom line: breastfeeding is the
best way to prevent iron deficiency anemia in babies. If breastfeeding
is not an option, or is stopped before 9-12 months, then iron-fortified
formulas, which contain added iron, should be given to baby instead
of whole cow's milk.
A recent study suggested that iron deficiency anemia in pre-teens
was associated with poor math scores. Although this is one study,
looking at it in the context that iron deficiency has been linked
to developmental/intellectual delays, it makes sense to ensure
adequate iron intake in the diet through-out childhood and adolescence.
Dietary sources of iron include red meat, liver, green leafy vegetables,
fruits, legumes and iron fortified cereals and breads.
On a final note, if supplemental iron drops or tablets are ever
prescribed, these should only be given as directed by a doctor
and be stored out of the reach of children, as accidental iron
over-dosage can be quite dangerous.
The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
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