Iron: Guidelines to Improve Your Child's Intake

What is iron?

Iron is a mineral everyone needs to keep their body working at its best. Iron works by forming hemoglobin, which is an important part of red blood cells. Hemoglobin carries oxygen to all parts of the body.

When the body does not have enough iron, a child can develop iron-deficiency anemia. This means the body cells get less oxygen. This causes the child to look pale and feel tired, weak, and irritable.

Hemoglobin

Red blood cells contain hemoglobin. Hemoglobin has iron atoms which bind to oxygen atoms. Thus red blood cells carry oxygen to all parts of the body.

What causes iron-deficiency anemia?

To be healthy, growing children need a constant supply of iron, otherwise their iron stores become low. Iron deficiency can occur in babies and children if they have a diet low in iron-containing foods, or if their bodies have trouble absorbing iron.

Possible causes of iron deficiency are:

• Drinking a lot of milk (more than 20 ounces, or 570 mL, per day) or juice (more than 4 ounces, or 115 mL, per day) every day. Children fill up with these low-iron fluids and do not get the amount of iron that their body needs.
• Drinking from a bottle after 2 years of age. These children are at a higher risk of iron-deficiency anemia than those who stop bottle-feeding earlier.
• Eating a diet poor in iron-containing foods.

Which foods are high in iron?

Iron is found in many animal and plant food sources.

• Iron from animal sources is called heme iron. Our bodies can absorb heme iron better than non-heme iron.
• Iron from plant sources is called non-heme iron. Our bodies can absorb non-heme iron when we eat it with foods that contain vitamin C (such as orange juice, citrus fruit, broccoli, strawberries, green or red peppers, or tomato sauce) or when we eat it with sources of heme iron.

The following table lists examples of heme iron foods and non-heme iron foods.

Getting enough iron at different ages

Babies

Breast milk contains enough iron to prevent anemia for the first 4 to 6 months of life. After this, babies need other sources of iron in their diet, such as iron-fortified cereal or meat.

If you choose to bottle-feed, use an iron-fortified formula until your baby is at least 1 year of age. Do not use "low iron" formulas. These formulas do not contain enough iron to meet your growing baby's needs.

To make sure your baby is getting enough iron, babies who are exclusively breastfed until 6 months of age can be offered meat or iron-fortified cereal as a first food.

• An iron-fortified infant cereal can be introduced at 6 months and can be continued until your child is 2 years old.
• Meat is an excellent source of iron. Meat dinners with vegetable have more meat, and therefore more iron, than vegetable dinners with meat.
• If you choose to offer your baby a vegetarian diet, try medium or firm tofu, peas, lentils, and beans.

Children and toddlers

Children and toddlers who drink a lot of milk or juice are at risk for iron-deficiency anemia. To help chidlren over 2 years of age get enough iron, you should:

• Remove all bottles and offer milk from a cup.
• Limit milk intake to 2 cups (16 ounces, or 450 mL) every day.
• Offer iron-containing foods every day.

How is iron deficiency treated?

Oral iron supplements (ferrous fumarate) are required to treat iron-deficiency anemia. Supplements should be taken as prescribed by your doctor. Iron supplements are absorbed best when taken with a source of vitamin C, or on an empty stomach. They are absorbed poorly if taken with meals. Iron supplements should not be taken with milk or dairy products.

Please speak to your doctor, dietitian, or pharmacist for more information about taking iron supplements.

Preventing iron deficiency: Tips to increase iron intake

Providing children with foods high in iron can increase iron stores and prevent iron deficiency from occuring.

• Limit cow’s milk to 2 cups (16 ounces, or 450 mL) per day.
• Limit juice to 1/2 to 1 cup (4 to 8 ounces, or 115 to 225 mL) per day.
• Serve beef, pork, lamb, chicken, dark turkey meat, or organ meats every day.
• Select cereal, bread, rice, and pasta with the words "enriched" or "fortified" on the label.

You can also try:

• Serving citrus fruit (orange, grapefruit, tomato) with iron containing foods to increase absorption: for example, hamburgers with orange juice to drink, orange wedges with meat, chicken wih broccoli, or spaghetti and meatballs with tomato sauce.
• Add dried peas or beans to soups and casseroles.
• Using liquid from canned peas and beans for gravies, soups, and stews.
• Serving liver pate or sardines on whole-wheat crackers or toast.
• Making liverwurst, canned corned beef, or sausage sandwiches.
• Sprinkling dried fruit (dates, raisins, prunes, apricots) on cereal.
• Adding raisins to lunches, favourite desserts, and hot cereal.
• Using oats, whole-wheat flour, and bran when baking.
• Adding blackstrap molasses to muffins, baked beans, gingerbread, and cereals.
• Adding beef to tomato or pasta sauce.
• Adding chunks of ham to macaroni and cheese.
• Serving baked beans with pork and tomato sauce.
• Using kidney, lima, or navy beans with cooking.
• Using whole-wheat or enriched breads and cereals.
• Serving cream of wheat or oatmeal for a snack.
• Offering water for thirst in between meals and snacks.

Key points

• Iron is a mineral that forms hemoglobin, which carries oxygen to the body.
• Without enough iron, a child can develop iron-deficiency anemia. This means the body gets less oxygen, causing the child to look pale and feel tired, weak, and irritable.
• Your child’s doctor may prescribe supplements if your child has iron-deficiency anemia.
• Eating certain foods can also increase your child’s iron levels.