My 15-month-old son was diagnosed as borderline anemic. I've tried giving him the iron drops prescribed but they seem to disagree with him, and now he will not take them. What can I feed him to bring up his iron levels? He dislikes meat.

Blood is a straw-colored liquid packed with red blood cells, white blood cells, and platelets (little clumps that help the blood clot when needed). The red blood cells carry oxygen from the lungs to every part of the body; they also give the blood its characteristic blood-red color. This steady supply of oxygen to the body's tissues is necessary for health, for growth, and for life itself.

When you don't have enough red blood cells in your blood, you have anemia. Anemia can make you feel tired, weak, and cranky. It can cause pale skin, headaches, and a poor appetite. Kids with anemia tend to get sick more often. Their brains and muscles are also affected.

The most common reason for a young child to be anemic is an inadequate supply of iron. Iron is a mineral that your body needs in order to make red blood cells. Children who lack enough iron will make small, pale, ineffective red blood cells.

Even before they are deficient enough to get anemic, children who are iron deficient don’t learn as well. Memory and school performance are decreased. Athletic performance suffers.

Children get iron deficiency anemia if they don't eat enough iron-containing food, if they lose too much iron (through bleeding), or if their need for new red blood cells is increased (as in periods of rapid growth). Thus, iron deficiency anemia is most common in infants and in adolescents (especially adolescent girls).

Most children get a blood test between 6 and 18 months of age to look for anemia. The blood test is important because it can identify anemia before there are any symptoms. In most children the anemia never gets severe enough to cause noticeable symptoms, but it can still slow cognitive development. Iron deficiency (even mild enough not to cause anemia) is associated with a decrease in attention span, in alertness, and in learning ability. Iron-deficient children are also more likely to eat dirt, paint chips, ice, and other mineral-containing items.

Irritability and fatigue are common in mild to moderate iron deficiency anemia. The white part of the eyes can take on a bluish tint. The child may appear pale.

Prolonged or severe anemia can cause marked irritability, decreased appetite, slowed growth, a swollen tongue, and flattened, spoon-shaped, or brittle nails. There may be irritated sores at the corners of the mouth. In very severe cases, children can even go into heart failure.

Anemia on the screening blood test is not necessarily caused by iron deficiency. Children will often have a brief, borderline anemia immediately following a viral illness. This will resolve on its own. Mild anemia in an otherwise well child is probably caused by iron deficiency.

Improving your child's diet is the most important way to prevent and to treat iron deficiency. Many foods are good sources of iron:

• Good -- Tuna, oatmeal, apricots, raisins, spinach, kale, greens, prunes
• Better -- Eggs, meat, fish, chicken, turkey, soybeans, dried beans, peanut butter, peas, lentils, molasses.
• Best --Breast milk (the iron is very easily used by the child), formula with iron, iron-fortified infant cereals, Cream of Wheat, Total, Product 19, other iron-fortified cereals, liver, prune juice.
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