Anemia is a condition where the body has a low number of red blood cells. Iron deficiency anemia happens when there is not enough iron in the body to make red blood cells. Iron deficiency anemia is the most common cause of anemia.

Red Blood Cells and Iron

• Red blood cells use iron to make a protein called hemoglobin.
• Hemoglobin in the red blood cells takes oxygen from the lungs to the body.
• Children and young adults who do not have enough iron in their bodies can develop iron deficiency anemia.

Causes of Iron Deficiency Anemia

When people do not have enough iron, they make fewer red blood cells and can develop anemia.

Causes of Low Iron

• Diets low in iron, from:
  • Not eating enough foods with iron in them
  • Drinking too much cow’s milk
  • Following a diet that does not offer a balance of vitamins and nutrients
  • Only breastfeeding after 6 months of age without starting solid food
• Difficulty with iron absorption:
  • Certain gastrointestinal and inflammatory disorders can cause the body to have problems taking in the nutrients from food.
• Blood loss that can be caused by:
  • Heavy menstrual periods
  • Bleeding inside the body, such as in the stomach, intestines or urine
• The body’s need for more iron during times when regular amounts of iron in the diet may not be enough. Examples include:
  • Pregnancy and breastfeeding: Women that are pregnant or breastfeeding need higher than normal amounts of iron.
  • Premature birth: Babies that are premature, or born before their due date, need more iron than other babies.
  • Growth spurts: Children under the age of 3 can grow so fast that their bodies need more iron than what they eat. This can happen when their diets do not include enough foods with iron.

Signs and Symptoms of Iron Deficiency Anemia

Many people with mild anemia may not have any symptoms. As anemia becomes more severe, a person may have some of the symptoms listed below:

• Weakness or feeling tired
• Pale skin
• Headache
• Loss of appetite
• Fingernail changes
• Cold hands and feet
• Fast heartbeat
• Shortness of breath or fast breathing
• Irritability and behavioral changes
• Feeling dizzy or lightheaded
• Delays with child development or problems with school performance
• Unusual cravings such as eating dirt or ice (pica)

Diagnosis of Iron Deficiency Anemia

Iron deficiency anemia may be suspected based on diet, symptoms of anemia, and a physical exam. Iron deficiency anemia can be confirmed by the following tests:

• A Complete Blood Count (CBC):
• Checks the amount of red blood cells and hemoglobin in the blood.
• Blood Smear:
• Looks at the red blood cells with a microscope. The red blood cells in iron deficiency anemia can be small and have less color.
• Iron studies:
• Checks the amount of iron in the blood and the amount of iron stored in the body (ferritin).

Additional tests may be needed to find the cause of iron deficiency anemia. Stool tests to check for hidden blood may be needed. Most stool tests are collected at home and returned to the outpatient lab. Families will receive instructions on how to collect these tests.

Treatment of Iron Deficiency Anemia

Finding out the cause is the first step in the treatment. Once the cause is identified, possible treatments include:

• Iron supplements in a pill or a liquid
• Iron that is given through a vein (intravenous):
  • This can be given in some cases, such as when a child cannot take iron by mouth.
• Making changes to your child’s diet such as:
  • Stopping or giving less cow’s milk
  • Eating more foods that are rich in iron
• Blood transfusions (for someone whose anemia and symptoms are severe)
• Treatments to reduce heavy menstrual periods
• Treating a disease that has contributed to the anemia

Prevention of Iron Deficiency Anemia

• Eat a balanced diet of vitamins and nutrients
• Eating more foods with iron such as:
  • Meats: beef, chicken, pork and seafood
  • Vegetables: mushrooms, broccoli, spinach, asparagus, potatoes with skin, peas, green beans
  • Other: fortified breads, cereals and pastas, raisins, nuts, eggs (yolks), dried apricots, watermelon
• Stopping or drinking less cow’s milk
  • Drinking too much milk can make it harder for the body to take in iron.
  • Drinking too much milk can cause children to fill up on the liquid. This can lead them to eat less solid food. Eating less healthy foods with iron can cause anemia.
  • Toddlers should not have more than six-20 ounces of cow’s milk in a day.