August 29, 2017

Iron deficiency

Iron deficiency is the most common micro-nutrient deficiency in the world and the largest group at risk includes pregnant women and young children. Iron is very important in child development, especially in the brain. In fact, iron deficiency during infancy can negatively impact thinking and emotions, behavior, movement, vision and hearing, learning and even memory. The younger the child, the greater the risk these effects are long-term. Therefore, the American Academy of Pediatrics (AAP) recommends universal screening of iron deficiency at 12 months of age.

Who is at greater risk?

Earlier testing may benefit some children. The AAP recommends pediatricians assess a baby's risks at 4 months of age to determine if either earlier screening is warranted or if an extra iron source should be added. Those with more risk factors are at greater risk of iron deficiency. Major, stand-alone risk factors include history of very preterm birth (<33 weeks) or small for gestational age (weight <10th percentile for age at birth). Other risk factors include history of prematurity (<37 weeks), low birth weight, birth weight too large for gestational age (>90th percentile), maternal diabetes during pregnancy, maternal obesity during pregnancy, multifetal gestation (twins, triplet, etc.), WIC eligible, ethnic minority status and exclusive breastfeeding beyond 4 months of age without a supplemental iron source.

Treatment for iron deficiency in newborns

Ferrous sulfate drops are the most common treatment choice for infants, but some children resist, making it difficult to give due to its metallic taste. If poor tolerance, alternative iron forms may be considered, such as the less bitter iron polysaccharide drops. Multivitamin drops with iron work to prevent iron deficiency, but generally do not provide enough iron, so ask your pediatrician about these. In addition to iron medicines, dietary changes that may improve iron status include increasing consumption of meat, grains (including iron-fortified cereal), legumes, fruits and vegetables. Typically, dietary changes alone are insufficient to treat iron deficiency so be sure to ask your pediatrician about treatment. You may also consider requesting a referral to a registered dietitian.

More information on iron deficiency in children

To offer more resources about iron deficiency, we designed a website for both families and providers with information regarding screening, risk factors, diagnosis, treatment and research on alternative iron sources. The goal of this website is to provide comprehensive information with a page for parents and a page for providers. The site can be accessed at

Please feel free to send any feedback on the site to