Iron deficiency anemia is a decrease in the number of red blood cells, caused by a lack of iron. This article focuses on iron deficiency anemia in children.

Iron deficiency anemia is the most common form of anemia. Iron is an essential part of hemoglobin, the oxygen-carrying protein in blood. Iron comes from the diet and by recycling iron from old red blood cells.

Babies are born with about 500 milligrams (mg) of iron in their bodies. By the time they reach adulthood they need to have about 5,000 mg.

Children need to absorb an average of 1 mg per day of iron to keep up with the needs of their growing bodies. Since children only absorb about 10% of the iron they eat, most children need to ingest 8-10 mg of iron per day. Breast-fed babies need less, because iron is absorbed 3 times better when it is in breast milk.

An iron-poor diet is a common cause of iron deficiency. Drinking too much cow's milk is a common cause of iron deficiency in young children because cow’s milk contains little iron and can get in the way of iron absorption. Cow's milk also can cause problems in the intestine that lead to blood loss and increased risk of anemia.

A common time for iron deficiency is between 9 - 24 months old. All babies should have a screening test for iron deficiency at this age. Babies born prematurely may need to be tested earlier. The adolescent growth spurt is another high-risk period.

Iron deficiency in children can also be related to lead poisoning.

• Pale skin color (pallor)
• Fatigue
• Irritability
• Weakness
• Shortness of breath
• Sore tongue
• Brittle nails
• Unusual food cravings (called pica)
• Decreased appetite (especially in children)
• Headache
• Blue-tinged or very pale sclerae (whites of eyes)

Note: There may be no symptoms if anemia is mild.

• Low hematocrit and hemoglobin levels
• Small red blood cells
• Low serum ferritin level
• Low serum iron level
• High iron binding capacity (TIBC) in the blood
• Blood in stool