Feature Articles
Anemia in Children: Tools for School
Your child’s school years are a period of learning, change and discovery. Children will acquire the knowledge and skills that will be vital to their future success in school and in life. Proper nutrition, including adequate iron intake, is essential for your child to grow and learn. Iron deficiency and iron deficiency anemia can have immediate and long-term effects on your child’s learning and development. Parents can help their children be at their best by taking some simple steps to prevent iron deficiency.
It is estimated that 1.2 million school-aged children in America are iron deficient.1 Often, a low-iron diet, limited access to healthy food, or medical conditions that affect iron status can put children at risk to develop iron deficiency.2 Children in lower-income homes are also at a higher risk than those in higher income homes. However, children from all backgrounds can develop iron deficiency and iron deficiency anemia.3
Why is iron important?
Dr. Lloyd Van Winkle, Family Practice physician and Clinical Associate Professor of Medicine at the University of Texas Health Science Center at San Antonio stated, “In school-aged children, iron deficiency is more than just an inconvenience. It is more than just tiredness. It can affect your child’s development and school performance.” Even before anemia might develop, iron deficiency can decrease attention spans, alertness, and learning in young children and adolescents.4
Recent studies have shown that children who are iron deficient have lower IQs,5 and score lower on standardized math tests and tests of mental capacity.5,6 In these studies, when the iron deficient children took iron supplements, all of these scores improved. Fortunately there are steps parent can take to prevent and treat iron deficiency and iron deficiency anemia in their kids.
Iron deficiency anemia is a condition that develops when a low iron level persists and prevents the body from making enough healthy red blood cells. The body can make red blood cells, even when it has an iron deficiency, but eventually the shortage of stored iron can slow that process and cause anemia.
Read More About Iron Deficiency: Information Handout
for School-Aged Children
| Age (Years) | Iron Intake (mg/day) |
| 4-8 | 10 |
| 9-13 | 8 |
| 14-18 | 11 (boys) 15 (girls) |
What can I do to prevent anemia in my child?
There are several steps parents can take to prevent their child from becoming iron deficient and possibly developing anemia. Dr. Van Winkle advises parents to “Make sure children have good nutritious food, especially iron fortified foods, and take a children’s multivitamin with iron every day.” Here are three tips to prevent iron deficiency in kids.
Good Food for Kids
A sensible way to help prevent your child from becoming iron deficient or anemic is to provide a diet naturally rich in iron. Try to include some lean cuts of red meat, beans, lentils, dark green leafy vegetables, eggs and nuts in your child’s diet regularly. Increase the intake of vitamin C-rich foods, including citrus fruits, berries, potatoes, broccoli, sprouts, tomatoes, peppers, and kiwis. Vitamin C helps the body absorb the iron in food.
Children from 1-5 years old should drink no more than 24 ounces (3 eight ounce glasses) of low-iron milk such as cow’s milk, goat’s milk, or soy milk each day. Drinking too much low-iron cow’s milk is a common cause of iron deficiency because it contains little iron and can get in the way of iron absorption. Cow’s milk can also cause problems in the intestine, like bleeding, and possibly iron deficiency anemia.
| Cereal Brand (TM) |
Iron Content per Serving (1 cup) |
| Rice Krispies | 9.6 mg |
| Frosted Flakes | 9.1 mg |
| Cheerios | 8.9 mg |
| Corn Flakes | 8.1 mg |
| Kix | 7.7 mg |
| Lucky Charms | 6.4 mg |
| Golden Grahams | 6.0 mg |
| Froot Loops | 4.2 mg |
Eat Your Wheaties™
Iron fortified breakfast cereals provide an excellent source of iron for children. A single serving of iron-fortified cereal can provide at least half of the recommended daily allowance of iron for children. In fact, ready-to-eat cereals are among the top sources of iron for children, as well as other vitamins and minerals, including folic acid, vitamin A, vitamin C, and zinc.7
Take Your Vitamins
It is important that children get the right amount of nutrients for growth and development. A daily multivitamin with iron can provide children with the extra nutrients they might not be getting in their everyday diets. However, remember that it is important to keep iron containing vitamins out of reach of children. Taking too much iron is a major cause of serious poisoning in children, according to the American Academy of Pediatrics.9
How can I tell if my child has iron deficiency anemia?
Iron deficiency is often first noticed during a routine exam, such as during a school physical. If your doctor suspects your child may be anemic, he or she may choose to do a simple blood test to measure your child’s hemoglobin level. Because the body’s iron supply is depleted slowly, some children with iron deficiency anemia don’t have symptoms that are easy to see. However, as anemia gradually gets worse, they may start to experience some noticeable symptoms, like tiredness, weakness, pale skin, rapid heartbeat, irritability, decreased appetite or dizziness.
How is iron deficiency treated?
If your child does have iron deficiency anemia, there are treatments available to help. Treatment includes an iron-rich diet, but this may not be enough to correct anemia once it had developed. Your child may also need to take an iron supplement for several months, which is described further in our Patient’s Guide to Oral Iron. Do not give your child an iron supplement without first consulting with a doctor because taking too much iron is a major cause of serious poisoning in children.9
If you are concerned that your child is not getting enough iron, be sure to talk with your child’s doctor. If iron deficiency is not treated, it may lead to long-term learning and behavioral problems.
For more healthy eating tips, read our feature article about The Importance of Iron in Nutrition.
References
- Halterman JS, Kaczorowski JM, Aligne CA, Auinger P, Szilagyi PG. Iron deficiency and cognitive achievement among school-aged children and adolescents in the United States. Pediatrics. 2001 Jun;107(6):1381-6. Link.
- Centers for Disease Control and Prevention. Recommendations to Prevent and Control Iron Deficiency in the United States. MWR 1998; 47(No. RR-3):25. Link.
- University of Maryland Medical Center. Health Library. In-Depth Patient Education Reports: Anemia. Link.
- The National Library of Medicine. Medline Plus Medical Encyclopedia. Iron Deficiency Anemia-Children. Link.
- Sachdev H, Gera T, Nestel P. Effect of iron supplementation on mental and motor development in children: systematic review of randomised controlled trials. Public Health Nutr. 2005 Apr;8(2):117-32. Link.
- Zlotkin S. Clinical nutrition: 8. The role of nutrition in the prevention of iron deficiency anemia in infants, children and adolescents. CMAJ. 2003 Jan 7;168(1):59-63. Link.
- United States Department of Agriculture. USDA Nutrient Database for Standard Reference: Release 14. Beltsville (MD): Nutrient Data Laboratory, Human Nutrition Research Center of the Agricultural Research Service (ARS); 2001. Link.
- Tenenbein M. Unit-dose packaging of iron supplements and reduction of iron poisoning in young children. Arch Pediatr Adolesc Med. 2005 Jun;159(6):557-60. Link.


