Pumping Iron

IMG_5069Isn’t there a saying that it’s the doctor’s child who always gets sick? Well, I’m pretty sure that applies to dietitians too.  Not that they get sick, although that does seem to happen all too often, but that they’re the kids who have feeding/eating/nutritional problems.  Or maybe it’s just my kid.  For example, G did NOT like drinking whole milk.  Even after he decided he was done nursing, he really didn’t want to drink it.  We tried different sippy cups and water bottles, warm and cold, and it still took him forever to start drinking milk regularly.  Even now he drinks less than 2 cups a day.  Typically, it’s the kids that are really heavy milk drinkers who are low in iron, but not my G.  Sure enough, when they checked his hemoglobin at his 1 year well check it was low.  Low enough that he needs iron supplements to boost it back up.  Maybe I’m the only mom with an iron deficient child, but maybe I’m not.  Either way, I hope this post can help some of you avoid the nasty (yes, I’ve tasted it) rust-colored supplement known as iron.

First, I’m going to nerd-out on you and we’ll just have a little biochemistry lesson. I’ll try not to bore you with too many details, but it’s good to understand why your sprout needs iron.  Iron is an element (think back to your high school chemistry days and the periodic table of elements) that is an important part of hemoglobin (a protein in our blood that carries oxygen…AKA the stuff we breathe that keeps us alive).  Iron also plays an important role in normal growth, development, and cellular function.  All good things right?? If your child becomes extremely iron deficient it is known as iron-deficiency anemia and has been associated with motor and cognitive impairment.  Not exactly what we want for your budding sprout.

 Typically, infants are born with enough iron to last them the first 4-6 months of life.  Drinking an iron-fortified formula provides enough iron to keep them going after the iron stores they are born with become depleted.  If your infant is breastfed, they probably need some type of iron supplementation after the first 6 months (1 mg/kg/day if you’re a numbers person).  Although breast milk is definitely higher in iron than cow’s milk, it still doesn’t provide quite enough for your growing sprout.  You can increase iron intake through either an actual supplement (check with your doctor first), or just by introducing iron-rich foods into their diet  What foods are iron-rich? I’m so glad you asked!  For starters:

  • Beef
  • Chicken
  • Turkey
  • Pork
  • Ham
  • Tuna
  • Salmon

And lots of other meats.  These are sources of heme iron (or iron from animals), which is absorbed better in your child’s gut.  But maybe, (like my G) your child is a budding vegetarian and prefers to get their iron from non animal (or nonheme) sources.  These would include:

  • Cooked cereals (i.e. oatmeal)
  • Cold cereals (i.e. cheerios)
  • Whole wheat bread
  • Beans
  • Spinach (and other greens…kale anyone?)
  • Broccoli
  • Peas
  • Dried fruit
  • Nuts
  • Wheat germs

Nonheme iron is not absorbed as well in your child’s gut.  Fortunately, we can encourage the iron in these foods to enter your child’s system by combining nonheme sources with heme sources (meat, fish, chicken…see above) or ascorbic acid (aka vitamin C).  Confused? Here’s what that looks like in real life.  Think giving your child an orange or strawberries (vitamin C) with their cheerios (nonheme iron source) in the morning.   Or making them a turkey (heme iron source) sandwich with whole wheat bread (non heme iron source).  How about adding a little salsa on top of their black beans or even making sautéed spinach with bacon (yum!).  Easy right?  Unfortunately, just like there are foods that increase iron absorption, there are also foods that inhibit it.  The most common one is milk.  If your child is drinking more than 2-3 cups/day, the calcium in the milk may be blocking the iron’s way into your child’s system.  Now you know why kids who drink gallons of milk can be iron deficient.   

If your child is iron deficient, try not to panic (although if you do, I can totally relate).  With a few simple dietary adjustments and a little planning, they’ll be back on track in no time.  If that doesn’t help, you can always talk to your doctor about a supplement (although overdosing on iron is a leading cause of fatal poisoning in children under 6 so definitely consult your pediatrician first).  And, if you add the supplement to a yummy fruit smoothie your child might even take it without a fuss.  If your doctor doesn’t automatically check your child for iron deficiency, consider asking them to! The 12 month and 18 month well checks are the perfect time to check it out (pun intended…)!  Keep pumping that iron for strong bodies AND strong minds!

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