Why do we need iron?
As parents, we often worry about how much our children need to eat and whether they are getting the nutrients they need. Children can often be fussy or picky eaters; their appetite may change from day to day, or they may start refusing foods they once loved. This may lead to children lacking in certain nutrients such as iron to meet the demands of their growing bodies.

 

Iron is an important mineral found in red blood cells and is mainly responsible for carrying oxygen around the body, which is needed for providing energy for daily life. Iron is also essential for muscle function, brain development and keeping the immune system working to fight disease.  

 
Iron deficiency and iron deficiency anaemia are the most common health problems in children and adolescents and affects girls more than boys. Recent data shows that 8.5% of boys and 14.8% of girls aged 2-3 years had inadequate iron intake. Similarly, 5.9% and 10.8% of boys and girls aged 4-8, and 3.3% and 10.5% aged 9-13 had inadequate iron intake.

Children can be at risk of being low in iron for a range of reasons including:

• Infants with a late introduction to solids
• Children <2 years old who drink large amounts of milk who may not be hungry to eat solid food, missing out on iron rich sources
• Fussy eaters may be at risk due to poor intake or lack of variety in the foods they eat
• Rapid growth that occurs during childhood
• Meat is difficult to eat and requires strength from the back jaw muscles so the teeth can grind the tough fibres.  At the end of the day children may be too tired to eat meat.
• Vegetarian and vegan eating
   

Signs and symptoms of iron deficiency in children include tiredness and weakness, shortness of breath, headaches, poor appetite, anxiety, hyperactivity, behavioural problems, poor sleep, and problems with concentration.

If you are concerned about your child, make an appointment with a doctor who can test for iron deficiency through a physical exam, medial history, and a blood test. It is also important to check your child’s vitamin B12 levels as it is common for those who are iron deficient to be low in vitamin B12. Vitamin B12 plays a key role in the formation of red blood cells, where iron is found, therefore, vitamin B12 deficiency may also contribute to iron deficiency.
 

 

There are two types of iron found in the diet.
1. Haem iron is found in animal foods and is easily absorbed by the body. Foods that contain haem iron include

• Meats: beef, lamb, pork, kangaroo
• Poultry: chicken and turkey
• Fish and shellfish: sardines, tuna, salmon
• Offal: liver and kidney
  à the darker the meat, poultry, fish or legume, the higher it is in iron

2. Non-haem iron is found in some plant foods and is not as easily absorbed. Foods that contain non-haem iron include

• Wholegrains: breads and cereals
• Iron fortified breakfast cereals
• Legumes: baked beans, beans, lentils, chickpeas
• Green leafy vegetables
• Dried fruit
• Eggs
• Nuts, seeds and pastes

Tips to get more iron in your child’s diet:

• Eat with your child even at snack times and eat the same foods. They will be more likely to try the food if they’re watching you and there are a lot of subliminal messages they will be picking up about how you enjoy eating!
• Offer 5-6 meals a day to give your child the chance to eat variety of foods across all food groups, helping to meet their iron and other nutrient requirements
• Offer water as the main drink throughout the day.  Milk and juices will fill up their bellies quickly and suppress their appetite for food. Think of milk as a food and if offering juice, dilute it 1 part juice to 10 parts water.
• Add lentils, kidney or cannellini beans into spaghetti, casseroles, soups, savoury mince dishes
• Choose breakfast cereals with added iron
• Use wholegrain breads / pasta / rice instead of white varieties
• Include nuts or seeds and their butters (peanut, cashew butter) to snacks  

 

Tips to maximise your child’s iron absorption

• Include vitamin C in their diet as this helps the body absorb more iron. Make sure your child has a variety of vitamin C rich foods like different fruit and vegetables offered at each meal and snack time. Offering frequently over the day will increase their intake of these foods too and provide a range of other essential nutrients such as fibre.  
• Tea, unprocessed bran, some soy proteins, and medications may block iron absorption. Avoid eating these at the same time of meals and snacks.

 

Here are some meal and snack suggestions

Breakfast:

• Weet-bix/ oat meal with milk and strawberries
• Wholemeal toast with eggs, tomato and spinach

Lunch

• Wholemeal sandwich with tuna with either tomato / beetroot + piece of fruit  
• BBQ Beef /kangaroo/lamb with potato and 3 different coloured vegetables
• Wholemeal wrap with hummus, egg, and 3 salad veggies like grated carrot, beetroot and baby spinach

 

Dinner

• Wholemeal pasta with tuna, tomato-based sauce with zucchini, mushroom and onion
• Chicken / beef / turkey meat balls with wholemeal pasta, broccoli, spinach and pumpkin
• Wholemeal toast with baked beans

 

Snacks

• Hummus/peanut butter with vegetable sticks: carrot/cucumber/capsicum
• Boiled egg on Vita-Weat crackers with tomato and cucumber

 

If your child does get enough iron from their diet but they are still deficient it may be from other causes including

• gastrointestinal conditions which affect the ability to absorb iron such as Coeliac disease, Inflammatory Bowel Disease or surgery affecting the intestine 
• Blood loss including from heavy menstrual bleeding, injury, ulcers or polyps in the gut
• Certain medications that may prevent iron absorption

A Dietitian can help assess your child’s diet to see if they are getting enough iron and work with your GP to organise medical testing and iron supplement prescription as required.

 

 

By Alison Knapp Dietetic Student