What can I do for my child’s iron deficiency anemia?

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, infant cereals, Cream of Wheat, Total, Product 19, other iron-fortified cereals, liver, prune juice.

The intestines of children who are being breastfed are two to three times more efficient at absorbing iron from every source. Taking vitamin C, or eating foods high in vitamin C (such as orange juice) at the same time as foods high in iron, also helps the body absorb and use the iron. The iron in iron-fortified foods is poorly absorbed, but usually contains enough extra iron to compensate for this.

Cooking in iron pans can help by adding iron to the food. Taking an over-the-counter multi-vitamin with iron can help provide a safety net for picky eaters.

Drinking too much milk makes anemia worse! Excess cow's milk can cause a child to lose iron through the intestines, and can also make it more difficult for the body to use the iron that is present. Most toddlers get sufficient calories and calcium from 16-24 ounces of milk daily. No child needs more than 32 ounces of cow's milk a day. Almost all cases of severe iron deficiency in young children are in those who drink too much milk.

If the anemia is severe, or if the diet isn't working, iron drops may be necessary to replenish your child's iron stores. The drops may be given with juice; they are both better tolerated and better absorbed. If they are given straight, they may turn the teeth dark. Iron drops can turn the stools dark and cause constipation, no matter how they are given.

The drops are usually given for about a month before a repeat blood test is performed to see if the anemia is resolving. If it is, the drops are given for another few months. If it is not, further investigation is needed into the many other possible causes of anemia.