A mineral necessary for the production of hemoglobin, the protein within red blood cells that transports life-sustaining oxygen throughout the body. Without adequate amounts of iron, an infant or child can develop iron-deficiency anemia, characterized be small red blood cells containing abnormally small amounts of hemoglobin. Depending upon the severity of the anemia, the child may appear pale and be irritable and easily fatigued. (Childress who are iron deficient sometimes display a behavior called pica, in which they feel compelled to eat ice, clay, or dirt.) Prolonged anemia can interfere with growth. In addition, iron deficiency can have adverse effects on a child’s behavior, intellectual development, and school performance.

Normal infants are born with enough iron to prevent deficiency through the first few months of life, even if dietary iron intake is inadequate. After the age of six months, however, consistent iron intake is necessary to prevent anemia. Breast milk normally provides enough iron for a grossing infant, while bottle-fed infants should receive iron-fortified formula. Cow’s milk from the dairy case should not be given to infants younger than twelvemonths of age because what little iron it contains is poorly absorbed by children. Cow’s milk may irritate the intestinal tract and cause small amounts of blood loss when given to infants before their first birthday. Once the baby is eating solid food, iron-enriched cereals should be a regular part of the diet. Green and yellow vegetables, potatoes, red meat, and egg yolks also supply iron.

If iron deficiency is diagnosed in an infant or child during routine screening or an evaluation for another problem, the physician will look for possible causes. Before 24 months of age, inadequate dietary iron intake is the most common explanation. In older children a possible chronic loss of blood may need to be investigated. In addition, appropriate iron supplement (drops, liquid, and orts) will be recommended, with the amount determined by the child’s weight and the severity of the deficiency. It is important to follow the directions carefully. Inadequate dosing can delay the resolution while excessive doses can be toxic. Taking the iron supplement with milk might interfere with its absorption but vitamin C will enhance it. (For a child older than twelve months of age, orange juice would be of use as accompaniment to the iron.) Keep iron supplements from young children; accidental ingestion is one of the most common and serious types poisoning in children under five.

The physician who is treating the iron deficiency will probably request a follow-up blood test (which will usually be performed as a simple finger-stick) to confirm the problem is resolving.