Iron deficiency is one of the most common mineral deficiencies among children just like among adults. It is estimated that almost 25% of children suffer from iron deficiency [1]. Why is iron important?

Iron deficiency develops mainly during the second year of life. First child´s iron stores are depleted (low ferritin) and when iron stores are almost depleted, iron deficiency anemia develops (low ferritin and hemoglobin) [2] [3].

Iron deficiency is common among children under 3 years and main causes of iron deficiency are increased iron need, small amount of iron from food and big consumption of cow milk products, especially consuming cow milk together with food. Nutrition therapist and Estonian Nutrition Therapy Association´s member of board Triin Muiste reminds that milk is food, not a drink. A lot of parents give their children cow milk as a drink together with food – the most important drink is water and parents should start practicing giving water to their children as early as possible. Other reasons for iron deficiency are absorption disorders and increased need for iron among children during growth phases.

How to know if your child suffers from iron deficiency?

There are many different symptoms in case of iron deficiency: tiredness, fatique, decrease in physical activity load, irritability, attention disorders, shortness of breath, headache, ringing in the ears, palpitations, onset or progression of heart failure, paleness, fragilile nails and hair, crevices in the corners of the mouth, painful tongue, loss of appetite, odd apptetite (need to eat chalk, cement, ice) [1]. In case of babies and toddlers, iron deficiency may also cause sleep disorders.

How is iron deficiency and anemia diagnosed?

Iron deficiency and anemia are diagnosed by blood sample. In case of iron deficiency, blood´s ferritin is low (body´s iron stores). Nowadays another test is used to check for iron deficiency, transferrin soluble receptors (higher value refers to iron deficiency). In case of iron deficiency anemia, blood sample shows low hemoglobin and hematocrit levels, red blood cells may be normal or a bit lower, red blood cell indices (MCV, MCH, MCHC) are usually lower.

When your child is suffering from iron deficiency, it is important to find out the cause. For example, iron deficiency may be caused by absorption disorders and then additional tests might be needed [1]. In case of babies and toddles, iron deficiency is often caused by increased iron need and too little iron intake from food because in case of babies and toddles, amount of food eaten is rather small.

What to do, when your child is diagnosed with iron deficiency?

In case of iron deficiency and iron deficiency anemia, usually prescription drugs or food supplements are needed that are prescribed by your doctor (in case of food supplements, first consult with your doctor). It is also important to find the cause. Hemoglobin normalizes usually within 4‒6 weeks. To fill your child´s body´s iron stores, treatment should be continued for several months up to half a year, because iron stores increase slowly.

All parents want their children the best and if possible, avoid different additives used in normal prescription drugs and food supplements. It is also easier to give your child iron in syrup form, because very small children cannot manage to swallow a pill. Babies´ intestine is still developing and iron supplements often cause several side effects, e.g. constipation, diarrhea, vomiting, stomach pain and a lot of toddlers refuse to take iron due to its characteristic metal taste.

Nôgel has developed the first iron syrup for children, where iron bisglycinate is used as iron salt. Research has found that iron bisglycinate is absorbed at least two times better compared to  iron sulphate, often used in breast milk substitutes [8] [9]. It has also been found that compared to iron-polymaltosecomplex, iron bisglycinate fills more effectively body´s iron stores [10]. Iron bisglycinate is stomach friendly and usually does not cause side effects. Nôgel´s iron syrup for children can be given to babies starting from 6 months´ age, who have been diagnosed with iron deficiency. Iron syrup can of course be also used by older children and adults. Nôgeli´s iron syrup for children consists of organic certified orange (natural vitamin C that contributes to iron´s better absorption), organic pear and a little bit of Estonian nettle tea, which we prepare ourselves from wild nettle harvested from a certain growth area. Nettle tea can be found from many liquid form iron supplements.

The content of iron and vitamin C have been checked in laboratory. One bottle is 250 ml and this is enough for 25 days if 20 mg (2 teaspoons) of iron is consumed daily. 20 mg daily iron is enough for small children to fill iron stores and treat anemia in case of iron bisglycinate. NB! Syrup´s batch currently sold in our online store is enough for 50 days, because daily dosage is 1 teaspoon, which consists of 20 mg of elemental iron. The information is also on the product label.


Sources:

[1] Tartu University Hospital – Iron deficiency anemia
[2] Aggett PJ, Barclay S, Whitley JE. Iron for the suckling. Iron nutrition in childhood. Acta Paediatr Scand 1989;78:96-102. 5.
[3] Male C, Persson LA, Freeman V, Guerra A, van’t Hof MA, Haschke F. Prevalence of iron deficiency in 12-mo-old infants from 11 European areas and influence of dietary factors on iron status (Euro-Growth Study). Acta Paediatr 2001;90:492- 8
[4] Vendt N, et al. Prevalence and causes of iron deficiency anaemia in infants aged 9 to 12 months in Estonia. Medicina (Kaunas) 2007;43:947–52
[5] Ekiz C, Agaoglu L, Karakas Z, Gurel N, Yalcin I. The effect of iron deficiency anaemia on the function of the immune system. Forum Nutr 2003;56:243-5.
[6] Wick M, Pinggera W, Lehmann P. Clinical aspects and laboratory iron metabolism, anemias: novel concepts in the anemias of malignancies and renal and rheumatoid diseases. 5th ed.
[7] Wien: Springer-Verlag; 2003. p. 7-16. 7. Lozoff B, Jimene E, Wolf A. Long-term developmental outcome of infants with iron deficiency. N Engl J Med 1991; 325:687-94
[8] Milman N, et al. Ferrous bisglycinate 25 mg iron is as effective as ferrous sulfate 50 mg iron in the prophylaxis of iron deficiency and anemia during pregnancy in a randomized trial. J Perinat Med. 2014 Mar;42(2):197-206. doi: 10.1515/jpm-2013-0153.
[9] Rossana B. et al. Efficacy of Supplementation with Iron Sulfate Compared to Iron Bisglycinate Chelate in Preterm Infants. Current Pediatric Reviews, 2018, 14, 00-00.
[10] J.Name et al. Iron Bisglycinate Chelate and Polymaltose Iron for the Treatment of Iron Deficiency Anemia: A Pilot Randomized Trial. Curr Pediatr Rev. 2018 Nov; 14(4): 261–268.

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