Iron deficiency in children - Anaemia

Anaemia caused by iron deficiency is very prevalent in India and in Indian children. Various studies have shown prevalence between 14% to 88% (!!) even in urban upper-middle class children¹. Doctors and paediatricians also tell us that they see a high prevalence of iron deficiency in India.

What is Iron deficiency anaemia?

Iron deficiency anaemia is caused through reduced iron in the body. Iron is used to produce haemoglobin, which in turn is used to produce red blood cells (RBC), RBC is used to transport oxygen to various parts of the body and this gets affected when iron is deficient.

Iron deficiency anaemia is problem that progressed gradually. It is not easy to recognize it at first, as the body adapts to the problem. But over time, it becomes more pronounced. Action needs to be taken early.

Symptoms of iron deficiency anaemia

• Fatigue, lack of energy
• Breathlessness
• Dizziness
• Paleness
• Easily irritable
• Decreased food consumption

Effects of iron deficiency in children

Prolonged iron deficiency can cause permanent effects like²

• Lower cognitive capability (ie., lesser intellgence)
• Reduce the ability to concentrate
• Memory loss
• Increased susceptibility to lead poisoning
• Decrease immunity

How to increase iron consumption - Babies/Infants (1 year or less)

• When you start solid foods at 6 months of age, use iron fortified cereal.
• If you feed your child homemade cereal at 6 months of age, talk to your paediatrician about how to add iron drops to your baby's diet.
• If you are giving your baby only breastmilk after 6 months of age, talk to your paediatrician about how to add iron drops to your baby's diet.
• Cow's milk is not recommended for babies for the first year. It contains very little iron and if an infant's appetite is reduced by consumption of cow's milk, they will not eat other iron containing foods.

How to increase iron consumption in children (More than 1 year)

From the age of 1, chldren typically transition to eating food that is cooked for the family (with a little less spice). The entire family should ensure that the diet contains foods that are rich in iron. If you buy any off-the-shelf foods (cereals etc.,), get the ones that are iron fortified. 

However, even if you eat a lot of foods rich in iron, the amount of iron your children get may not be enough (especially vegetarians who also drink a lot of cow's milk). So keep an eye open for the symptoms described above If you notice the symptoms, talk to your paediatrician about giving them an iron supplement. 

Foods that are rich in iron are: 

• Cereals & Grains
  • Bajra, Kambu, Sazzalu
  • Rice flakes, Chewra, Aval, Chira, Pohe, Atukulu
• Pulses & Beans
  • Cow pea, Lobia, Karamani, Chorap, Barbati
  • Lentils, Masur
  • Soyabean
• Vegetables
  • Beetroot greens, Chukandar-ka-sag
  • Makoy leaves, Manathakali leaves, Piludi, Kamanchi, Kakmachi
  • Mint, Pudina
  • Parsley
  • Turnip greens, Shalgam-ka-sag
• Condiments & Spices
  • Turmeric, Haldi
• Fruits
  • Dried dates, Khajur
  • Water melon
  • Raisins, Kishmish
• Fish
  • Goggler, Labi, Chamban
  • Ribbon fish, Rupa patia, Savalai, Savala
• Meats
  • Red meats

References

1. G. Srihari, A. Eilander, S. Muthayya, A.V. Kurpad and S. Seshadri, "Nutritional Status of Affluent Indian School Children: What and How Much Do We Know?", Indian Pediatrics 2007; 44:199-203 

2. "Preventing Iron Deficiency in Women and Children: Background and Consensus on Key Technical Issues and Resources for Advocacy, Planning and Implementing National Programmes", UNICEF/UNU/WHO/MI Technical Workshop, UNICEF, New York , 7–9 October 1998