What is iron-deficiency anemia?
Iron-deficiency anemia is a type of anemia that happens when your child’s body does not have enough iron to make hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen throughout the body.
Symptoms of iron-deficiency anemia
Signs and symptoms of iron-deficiency anemia can be mild at first but can become more severe over time. Common symptoms include:
- Fatigue (feeling tired or weak)
- Feeling dizzy or lightheaded
- Pale skin or pale color inside the lower eyelids
- Fast heartbeat or feeling like the heart is racing or pounding
- Shortness of breath
- Headaches
- Cold hands and feet
- Pica: craving or eating items that are not food, such as dirt, paper, chalk, or ice
Causes of iron-deficiency anemia
Iron-deficiency anemia can happen for several reasons, including:
- Not getting enough iron in your diet: If your child does not eat enough foods rich in iron, their body will not get the iron it needs. Iron-rich foods include meat, beans, and green leafy vegetables.
- Blood loss: Losing blood due to surgery, injury, bleeding of the gastrointestinal (GI) tract, or heavy menstrual periods can lead to low iron levels.
- Problems absorbing iron: Some health problems, medicines, or surgeries that affect the gastrointestinal (GI) tract can make it hard for your child’s body to absorb iron from the food they eat.
- Increased need for iron: The body may need more iron due to growth spurts, pregnancy, or breastfeeding.
- Other medical conditions: Some genetic conditions, kidney disease, and other health problems can affect how the body uses iron.
Diagnosis of iron-deficiency anemia
Iron-deficiency anemia is diagnosed based on your child’s medical history, physical exam, and lab tests. Lab tests may include a complete blood count (CBC) test to measure the number and size of blood cells.
Your child’s care team may also order blood tests such as ferritin (iron storage) or other iron studies to confirm iron deficiency.
Your care team will compare your child’s test results with normal ranges for children of the same age and discuss them with you.
Treatment of iron-deficiency anemia
Treatment depends on the cause and severity of your child’s iron-deficiency anemia. Your child’s care team may refer your child to a hematologist, a doctor who diagnoses and treats blood disorders.
If blood loss or another health issue is the cause, treating that problem is important.
Other treatments may include:
- Eating iron-rich foods: Good sources of iron include lean red meat, poultry (chicken, turkey, duck, goose), seafood, beans, lentils, tofu, spinach and other dark green leafy vegetables, iron-fortified cereals and breads, peas, and dried fruit.
- Eating foods rich in vitamin C: Vitamin C can help your child’s body better absorb iron. Good sources of vitamin C include oranges, strawberries, and tomatoes.
- Iron supplements given by mouth
- Iron infusion given by vein through an IV
- Blood transfusion to quickly increase the number of red blood cells (in rare cases of severe anemia)
Prognosis for iron-deficiency anemia
With the right treatment, most people start to feel better in a few weeks to a few months. The outlook can depend on the cause of anemia.
- If anemia is due to a temporary issue, such as blood loss, anemia usually improves once the underlying cause is treated.
- If the anemia is due to a long-term condition, ongoing care might be needed to keep iron levels normal.
Without treatment, iron-deficiency anemia can lead to health problems, including delayed growth and development, learning or behavior problems, and heart problems in severe cases.
How to manage iron-deficiency anemia
Eat a healthy diet
Make sure your child eats foods rich in iron and vitamin C. These foods will help your child’s body absorb iron better. A dietitian can help you know if your child is getting the nutrients they need.
Give iron supplements as prescribed
Your care team may prescribe iron by mouth, such as a pill or liquid. Here are some tips to make the iron work well and prevent side effects. Always follow the instructions given by your care team.
- Give iron on an empty stomach: Your child’s body absorbs iron best when the stomach is empty. Try to give the supplement 1–2 hours before or after meals. If your child has an upset stomach, give with a small amount of food or at bedtime.
- Do not give iron with foods, drinks, or medicines that have calcium: Calcium keeps the body from absorbing iron.
- Give the iron with orange juice: Giving iron with a source of vitamin C, such as orange juice, can help the body absorb it better. Avoid giving iron with milk.
Iron supplements can cause side effects such as dark stool (poop), constipation, stomach upset, nausea, or diarrhea. Talk to your care team about these side effects. They may recommend medicine, diet changes, or a different way to take iron.
Give all medicines as directed by your care team.
Monitor your child’s symptoms
Keep a record of how your child feels. If your child feels weak or dizzy, your care team may suggest taking rest breaks and ways to prevent falls. Fall prevention methods may include:
- Getting up slowly from a lying or sitting position
- Getting help with walking, using stairs, or other activities
- Decluttering areas to prevent tripping over things
Your child's care team will order follow-up blood tests to make sure iron levels and hemoglobin are improving. Regular check-ups, lab tests, and sticking to the treatment plan are important for a good outcome. If your child’s symptoms get worse, talk to your care team.
Questions to ask your care team
