IRON DEFICIENCY IN CHILDREN


What is the

role of iron in the diet

?

Iron is essential for life, because it is indispensable for several biological reactions such as oxygen transport, DNA synthesis and cell proliferation. It is important for formation of hemoglobin in the body.

Who are at risk of

iron deficiency

?

Infants and toddlers represent a risk population for iron deficiency (ID), due to their relatively high requirements, which are frequently associated with a poor intake of iron-rich foods.

What are the health

consequences of iron deficiency

?

A possible association between iron deficiency in infancy and early childhood and impaired cognitive and psychomotor development has been described, and it has been suggested that some of these effects can be irreversible. Iron deficiency impairs growth in children.

How common is iron deficiency in India?
In India prevalence of anemia at all ages remains very high e.g. 84.9-86% pregnant women in rural areas are affected and 9.3-9.9% have severe anemia, 64% children between 9-36 months of age as anemic with 7.8% having severe anemia.

What are the
symptoms of iron deficiency
?

Children with iron deficiency
can have fatigue, irritability, palpitation. dizziness, breathlessness and headache. They may have gastritis, a smooth bald tongue due to loss of papillary growth, softness of the nails leading to flattening and spooning of nails (called as koilonychias) and poor body temperature control. Some children will also start eating mud or clay (pica).

What are the causes of iron deficiency in children?
Common causes of iron deficiency in children are eating a diet poor in iron and worms in the intestines such as round worms and hook worms which lead to loss of iron in stools. Other causes are malaria and blood loss.

How is the diagnosis of iron deficiency made?
During initial stages of iron deficiency, the liver, spleen and bone marrow show reduced iron stores. This can be detected by doing blood ferritin levels which are low. Soon the blood iron content is also decreased and bone marrow does not get any iron for formation of hemoglobin. This can be detected bydecreased transferrin saturation < 16% and increased free erythrocyte porphyrin. Subsequently the hemoglobin levels fall causing iron deficiency anemia.

What is the daily iron requirement for normal growth?
Daily iron requirement in various age groups is depicted in Table given below:
AgeIron needs in mg/kg
Birth weight gm< 10004
Birth weight gm1000-15003
Low birth weight2
Full term1
Upto 10 years10 mg/ day
> 11years (Girls)15 mg/day
> 11years (Boys)12 mg/day
Pregnant30 mg/day



What is the treatment of iron deficiency?
Treatment of iron deficiency consists of supplementation of iron. Iron can be given as syrups, tablets and even injections.

How can iron deficiency be prevented? Which are foods rich in iron?
Baby should be breast fed colostrum and mature milk. Both have 49% absorbable iron. This is sufficient with available stores till baby doubles the birth weight. Weaning foods should have one iron rich dietary item. Foods rich in iron can be consumed such as green leafy vegetable, mustard leaves (sarson), amaranth (chauli), colocasia leaves (arvi), bengal gram greens (channa), shepu of sow, turnip greens (shalgum), radish green (mooli), spinach (palak), cereals and sprouted pulses, jaggery (gur), meat ,fish, and liver. Iron absorption is enhanced from diets having ascorbic acid/vitamin C such as lime, lemon, orange, amla, green mango etc. Fortification of with iron can also help to prevent iron deficiency.
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