Iron is a vital mineral that helps carry oxygen throughout the body, so when levels drop, your child can feel it in more ways than one. From chronic fatigue to slowed growth, low iron can have a significant impact on your child’s energy, development and overall health. While iron deficiency is common in children, knowing when it’s cause for concern can help you take action before symptoms get worse

what does iron do in the body? 

Iron is a building block for hemoglobin, a protein in red blood cells that helps deliver oxygen to tissues and organs. Without enough iron, the body can’t produce healthy red blood cells, which can result in iron deficiency anemia. This can affect everything from your child’s brain development to immune function.

what causes low iron in kids? 

Several factors can contribute to low iron levels, especially in growing children:

• Limited intake of iron-rich foods: Picky eating, vegetarian diets or excessive milk consumption can lead to nutritional gaps.
• Rapid growth: Children, especially during infancy and adolescence, have higher iron needs.
• Blood loss: Conditions like heavy periods or gastrointestinal bleeding can reduce iron levels.
• Chronic illnesses or poor absorption: Disorders like celiac disease can interfere with how the body absorbs iron.
• Premature birth or low birth weight: Babies born early may have lower iron stores at birth.

signs and symptoms of low iron in children

Because symptoms can come on gradually, it’s easy to miss them at first. Watch for:

• Pale skin or lips
• Fatigue or weakness
• Irritability or behavioral changes
• Cold hands and feet
• Shortness of breath during activity
• Slow weight gain or poor appetite
• Brittle nails or thinning hair
• Frequent infections
• Difficulty focusing at school

Even if symptoms seem mild, it’s important to talk to your pediatrician if they persist or begin affecting your child’s daily life.

how is low iron diagnosed? 

If your pediatrician suspects low iron, they’ll start with a physical exam and a few simple blood tests. These might include:

• Hemoglobin and hematocrit: To check red blood cell counts
• Ferritin: To measure iron storage
• Serum iron and total iron-binding capacity: To see how much iron is in the blood and how well it’s being carried

In some cases, additional tests may be needed to determine if poor absorption or another medical condition is at play.

when to be concerned about low iron

Occasional tiredness or picky eating may not be cause for alarm, but there are situations when low iron becomes a medical concern:

• Your child is unusually tired, pale or weak for days or weeks
• Growth and weight gain have slowed noticeably
• There are frequent headaches, dizziness or shortness of breath
• Your child avoids physical activity or can’t keep up with peers
• Behavioral or attention issues begin to impact school

Iron deficiency that progresses to anemia can cause long-term developmental issues, especially in infants and toddlers.

treatment options for low iron

Treatment depends on the severity of the deficiency. Your pediatrician may recommend:

• Iron-rich foods: Include lean meats, beans, leafy greens, fortified cereals and iron-fortified formulas (for babies)
• Iron supplements: These are often prescribed for moderate to severe deficiency and may come in drop, liquid or tablet form
• Vitamin C pairing: Serving vitamin C-rich foods like strawberries or bell peppers with iron sources can improve absorption
• Reducing excess milk intake: Especially in toddlers, too much cow’s milk can interfere with iron absorption

Your child will likely need follow-up bloodwork to confirm improvement.

preventing low iron in the future

Some cases of low iron are unavoidable, but there are steps you can take to help prevent it:

• Start iron-rich complementary foods around 6 months of age
• Choose iron-fortified infant cereals and formulas when needed
• Encourage a balanced diet with whole grains, vegetables and lean proteins
• Monitor milk intake in toddlers
• Continue routine pediatric checkups to monitor growth and development

If your child has had low iron before, your provider may recommend routine screening or long-term dietary changes.

pediatric care at dayton children’s 

While most iron deficiencies can be managed with your pediatrician, they may refer you to see a pediatric hematologist for additional screening and testing. Hematologists specialize in disorders of the blood including iron deficiency. At Dayton Children’s, our hematologists work with families to uncover the root cause and provide personalized care for long-term health. Schedule an appointment online or by calling 937-641-4000.