Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues. There are many types of anemia.
Iron helps make red blood cells and helps these cells carry oxygen. A lack of iron in the body may lead to anemia. The medical name of this problem is iron deficiency anemia.
Anemia caused by a low iron level is the most common form of anemia. The body gets iron through certain foods. It also reuses iron from old red blood cells.
A diet that does not have enough iron is the most common cause of this type of anemia in children. When a child is growing rapidly, such as during puberty, even more iron is needed.
Toddlers who drink too much cow's milk may also become anemic because too much cow's milk makes it difficult for the body to absorb iron. Also, children who drink too much cow's milk may not eat enough other healthy foods that have iron.
Other causes may be:
- The body is not able to absorb iron well, even though the child is eating enough iron.
- Slow blood loss over a long period, often due to menstrual periods or bleeding in the digestive tract.
Iron deficiency in children can also be related to lead poisoning.
Mild anemia may have no symptoms. As the iron level and blood counts become lower, your child may:
- Act irritable
- Become short of breath
- Crave unusual foods (pica)
- Eat less food
- Feel tired or weak all the time
- Have a sore tongue
- Have headaches or dizziness
With more severe anemia, your child may have:
- Blue-tinged or very pale whites of eyes
- Brittle nails
- Pale skin
Exams and Tests
The health care provider will perform a physical exam.
Blood tests that may be abnormal with low iron stores include:
A measurement called iron saturation (serum iron level divided by the TIBC value) can help diagnose iron deficiency. A value of less than 15% supports the diagnosis.
Since children only absorb a small amount of the iron they eat, most children need to have 3 mg to 6 mg of iron per day.
Eating healthy foods is the most important way to prevent and treat iron deficiency. Good sources of iron include:
- Chicken, turkey, fish, and other meats
- Dried beans, lentils, and soybeans
- Peanut butter
- Prune juice
- Raisins and prunes
- Spinach, kale and other green leafy vegetables
If a healthy diet does not prevent or treat your child's low iron level and anemia, your provider will likely recommend iron supplements for your child. These are taken by mouth.
Do not give your child iron supplements or vitamins with iron without checking with your child's provider. The provider will prescribe the right kind of supplement for your child. Too much iron in children can be toxic. Supplemental iron is usually prescribed to be taken by mouth, but may also be given intravenously (through a vein).
With treatment, the outcome is likely to be good. In most cases, the blood counts will return to normal in 2 to 3 months. It is important that the provider finds the cause of your child's iron deficiency.
Anemia caused by a low iron level can affect a child's ability to learn in school. A low iron level can cause decreased attention span, reduced alertness, and learning problems in children.
A low iron level can cause the body to absorb too much lead.
Eating a variety of healthy foods is the most important way to prevent and treat iron deficiency.
Anemia - iron deficiency - children
Fleming MD. Disorders of iron and copper metabolism, the sideroblastic anemias, and lead toxicity. In: Orkin SH, Fisher DE, Ginsburg D, Look AT, Lux SE, Nathan DG, eds. Nathan and Oski's Hematology and Oncology of Infancy and Childhood. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 11.
National Heart, Lung, and Blood Institute website. Iron-deficiency anemia. www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia. Accessed June 20, 2022.
Rothman JA. Iron-deficiency anemia. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 482.
Review Date 1/1/2022
Updated by: Adam S. Levy, MD, Division of Pediatric Hematology/Oncology, The Children's Hospital at Montefiore, Bronx, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.