Anaemia iron deficiency living in children

Overview

Iron deficiency anaemia in children is a condition where the body doesn't have enough iron to make healthy red blood cells. Red blood cells carry oxygen around the body, so without enough iron, your child may feel tired, weak, or pale.

Yes, iron deficiency anaemia is common in children, especially in toddlers and teenagers who are growing quickly.

It mostly affects babies and young children (especially those born early or with low birth weight), children who do not eat enough iron-rich foods, and teenagers during growth spurts or with heavy periods.

Symptoms

Common symptoms

• Feeling tired or weak
• Pale skin (especially lips, nails, and inside the eyelids)
• Cold hands and feet
• Fast heartbeat or shortness of breath when playing
• Feeling dizzy or lightheaded

Symptoms in children

• Poor appetite or refusing to eat
• Slower growth and development
• Being irritable or fussy
• Wanting to eat non-food items like dirt or ice (this is called pica)
• Getting infections more often

Causes

Main causes

• Not getting enough iron from food (common in picky eaters or children who drink too much cow’s milk instead of eating iron-rich solids)
• The body cannot absorb iron properly due to conditions like celiac disease or stomach infections
• Blood loss (for example, from a stomach ulcer, certain parasites, or heavy periods in teenage girls)

Risk factors

• Being born prematurely or with a low birth weight
• Being exclusively breastfed after 6 months without iron-fortified baby foods
• Drinking a lot of cow’s milk (over 500ml a day) in young children
• Rapid growth during infancy and adolescence
• Having a chronic illness like inflammatory bowel disease

When to see a doctor

See a doctor urgently if:

• Your child has trouble breathing or complains of chest pain
• Your child faints or seems very confused

Book a routine appointment if:

• Your child has been tired or pale for more than a few weeks
• Your child is not growing as expected
• You notice your child eating non-food items

Diagnosis

A doctor will ask about your child’s symptoms, eating habits, and growth. They will then do a simple blood test to check iron levels and red blood cell count.

Tests that may be done

• Complete blood count (CBC) – to see if red blood cells are low and small
• Ferritin test – to check the body's iron stores
• Sometimes other tests to find the cause, like checking for hidden blood loss or absorption problems

What to expect at your appointment

The blood test is quick and a little pinch. The doctor may ask about your child’s diet, activity level, and any medicines. Based on results, they will recommend a treatment plan.

Treatment

Treatment aims to raise iron levels in the body so your child can make healthy red blood cells. This is usually done with iron supplements and changes to what your child eats.

Self-care at home

• Give your child more iron-rich foods like lean red meat, chicken, fish, eggs, beans, lentils, and dark leafy greens (like spinach)
• Pair iron-rich foods with vitamin C foods (like oranges, strawberries, or tomatoes) – this helps the body absorb more iron
• Limit cow’s milk to no more than 500ml a day for young children, as too much milk can reduce iron absorption
• Avoid giving tea or coffee to children – they can block iron absorption

Medical treatments

Doctors often prescribe iron supplements (usually as liquid drops or tablets) for a few months. The dose and type will depend on your child’s age and how low their iron is. Follow your doctor's instructions carefully, and do not give extra doses. Some children may need a vitamin C supplement along with the iron. In rare cases, if iron levels do not improve, a doctor might recommend iron given through a vein (infusion) or hospital treatment.

When is surgery considered?

Surgery is not used for iron deficiency anaemia unless there is a specific cause like a bleeding source that needs to be fixed (for example, a bleeding ulcer or parasite removal).

Living with this condition

With treatment, your child can lead a normal, active life. Offer iron-rich meals and snacks, and remember that it may take a few weeks to see improvements. Keep follow-up appointments so the doctor can check progress.

Lifestyle tips

• Encourage physical activity as your child feels better – play helps build strength and energy
• Create a calm mealtime routine to help your child eat well
• Keep a food diary to track iron-rich foods they eat

Diet and exercise

Focus on iron-rich foods every day. Include a source of vitamin C with meals (like half an orange or a small glass of orange juice). Limit milk and avoid tea with meals. Exercise is fine – let your child rest if they feel tired.

Mental health and emotional wellbeing

Anaemia can make children feel tired and grumpy, which might affect their mood or behaviour. It can also make them less interested in playing or school activities. Treating the anaemia usually helps emotions return to normal. If you worry about your child’s mood or development, talk to your doctor.

Prevention

Yes, in many cases. You can help prevent iron deficiency by offering iron-rich foods from around 6 months of age (when starting solids), not giving too much cow’s milk, and ensuring your child eats a balanced diet. For babies who are breastfed after 6 months, your doctor may recommend iron supplements.

Screening programmes

Routine screening is not done for all children, but your doctor may check iron levels if your child has risk factors like being premature or having certain health conditions. Speak to your doctor if you have concerns.

Complications

If left untreated

• Slower growth and development
• Learning difficulties or trouble concentrating in school
• Weaker immune system, leading to more infections
• Heart problems, like an irregular heartbeat or heart failure in severe cases

Long-term outlook

The outlook is very good. With early treatment and dietary changes, most children recover fully and have no lasting problems. Iron levels usually return to normal within a few months. If your child has an underlying condition, managing that will also help. You and your child’s healthcare team can work together to keep them healthy and strong.

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