Episode 10: Dietary Iron for children - what every mum needs to know.

Episode 10: Dietary Iron for children - what every mum needs to know

Iron Deficiency is a global concern -impacting an alarming 293 million preschool children globally, with 50% of anemia cases attributed to it. Surprisingly, in Australia, 20% of young children aren't getting enough iron in their daily diets. The World Health Organization flags iron deficiency anemia as the most common nutritional shortfall, affecting a staggering 30% of the world's population.

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https://nourishwithkarina.com/feedingbabies
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Highlights:

Introduction (00:00.078)

Iron Deficiency: A Global Concern (00:29.742)
Improving Children's Iron Intake (02:57.902)
Iron Deficiency Anaemia in Children (05:24.654)
Children who don't eat meat (09:33.518)
Iron Absorption in Children (12:00.814)
Boosting Child's Dietary Iron Intake (16:43.982)
Reorienting Iron Feeding for Children (19:02.094)
Iron Supplementation for Children (21:04.622)
Tips and Tricks (23:27.662)

Show notes

READ TRANSCRIPT

Show Notes

Join me in this episode as we:

1. Uncover the Significance of Iron : We'll unravel why iron is so crucial, playing a key role in brain development, oxygen transport, and energy metabolism.

2. Dive into types of Dietary Iron : Let's break down the difference between haeme iron from animal sources and non-haeme iron from plant foods, offering insights for parents navigating their children's nutrition.

3. Navigate Factors Influencing Iron Deficiency in Children : We'll discuss the challenges children face, from introducing solids to dealing with excess milk consumption or following specific diets.

4. Identify Iron Deficiency Symptoms : Learn to recognise physical signs in your little one that might indicate iron deficiency.

5. Equip Yourself with Strategies to Boost Iron Intake : Discover practical tips and creative hacks to enhance your child's dietary iron intake, addressing common challenges faced by parents.

As a mum and a paediatric dietitian, I get the struggles parents go through to ensure their children get the right nutrition. Iron deficiency can be daunting, but this episode aims to empower you with knowledge and strategies to safeguard your child's health.

So, if you're keen to equip yourself with actionable insights to improve your child's iron intake and reduce the risk of iron deficiency, listen in now. Don't forget to subscribe, share, and leave a review – your support helps us reach more families. Until next time, take care!

Learn more about my membership program, head over to: https://nourishwithkarina.com/membership

Introduction (00:00.078)
You're listening to the Easy Feed Podcast, episode number 10, Iron Deficiency in Children. Hi there, I'm Karina Savage and with over 20 years experience feeding children, including my own, I've learnt all the secrets that busy mums need to get their children eating better and actually enjoying healthy foods. So a huge welcome to the Easy Feed Podcast.
Iron Deficiency: A Global Concern (00:29.742)
Welcome back. It's great to have you here. Today we're talking about a topic that affects people globally. Children, adults, everybody. Iron deficiency is a worldwide concern. About 293 million preschool children are estimated to have anemia, of which about 50 % of these cases are caused by iron deficiency.
Did you know that 20 % of young children in Australia consume inadequate dietary intakes of iron to meet their daily needs? This is a global problem. The World Health Organisation has recognised iron deficiency anemia as the most common nutritional deficiency in the world, with 30 % of the population being affected with this condition. So let's start by talking about what is iron?
Well, iron is an essential element in our body. We need it. It plays a key role in many biochemical processes, including brain development in children, oxygen transport around the body, and energy metabolism. It is needed by almost every cell in the body to function properly. Dietary iron can be found in two forms. So we have haeme iron and non -haeme iron.
Sorry to get specific, but it's kind of important. So haeme iron is from animal sources, meat, chicken, fish, and it's easily absorbable. Non -haeme iron is mostly found in plant foods and eggs, and it's not as easily absorbable, but there's plenty we can do to improve the absorption, and I'll talk about that a little later. Children need to eat a variety of foods that contain iron every day to make sure that they have enough.
iron in their body. In fact, babies and children are one of the groups most at risk of iron deficiency. Not only because they physiologically have increased iron requirements due to their stage of growth and development, but sometimes they struggle to actually eat the amount of iron that they require. You know, a 12 -month -old baby has the same iron requirements as a grown man? It's incredible.
Improving Children's Iron Intake (02:57.902)
And this is why I think we see so much iron deficiency because the requirements in children are so big, but they're still just trying to, you know, learn how to eat these foods and increase their intake of dietary iron. And I'll talk about other factors that make it harder as well for our children. So I'm here to help you improve your child's dietary iron intake so that they're not at risk of iron deficiency.
So here are some situations that may further increase a child's risk of low iron stores or iron deficiency. So we have babies who are not eating solids from around the age of six months. And this can increase iron deficiency risk because by six months, the stores that babies were born with have run out. So they don't have any of their stores that they were born with that were passed to them from their mother. And...
At this point, breast milk really contains very little iron. So if they're still being breastfed, they're not getting much iron from the breast milk. And so that's why it's really important that they start solids for around the age of six months to start to replenish their iron stores. Children who drink too much milk, so greater than a couple to a day, are at increased risk of iron deficiency. Busy eaters who have a poor variety in their intake.
are at risk. Children following a vegetarian or vegan diet are more at risk. And kids on reflux medication are more at risk of low iron or iron deficiency. So what actually is iron deficiency? Well, iron deficiency is when your blood and also your stored levels of iron, otherwise known as ferritin, it's when they drop below normal levels. And this can only really be found out by a blood test.
In babies and children, this can show symptoms of, might be dark circles under their eyes, might be that they've got restless legs. It might be that they have difficulty getting to sleep or staying asleep. It might be that they have achy legs. I've certainly had little ones where they've gone back on their iron supplementation and their achy legs have gone, which is great. Tiredness, lethargy, appetite, a loss. So it can really affect appetite. So iron and zinc deficiency can...
Iron Deficiency Anemia in Children (05:24.654)
definitely knock off appetite and children. And it can sometimes also cause headache, although that tend to be in the more oven. We'll leave that last bit off.
Iron deficiency anaemia is when iron levels are so low that they affect the haemoglobin levels in your blood, which means that your body's ability to carry oxygen around the body is affected. And in children, this can show you symptoms of very pale skin, tiredness and weakness, shortness of breath. They might get this condition called pica, which is cravings for non -food items like
clay and dirt and chalk, they might lick metal objects. They may have behavioural problems, learning difficulties, they might get brittle hair or nails. Again, appetite can get affected even more so in an anaemic state. And it can also affect immune function, making kids more vulnerable to infections. Other signs, and again, you know, this is what a doctor would look for as well, but you could get, they could have...
pale insides of the lower eyelids and pale crease lines. So when you pull your palm of your hand, you pull the fingers back slightly and you see the crease lines in your hands. If those crease lines are more pale, then that can also be an indication.
And as I said, in children, babies and children, iron deficiency, anaemia can definitely impact on brain growth and development. And this is something that we really need to be mindful of because we want to give our children the best chance at life. And iron deficiency can really affect that. Now I've got a feeling that at this point, I'm starting to stress parents out if they're listening. Now I've got a feeling at this point that I'm probably starting to stress you out.
Don't stress, there is no judgment (07:22.894)
I apologize for that. We'll get to the good stuff, I promise. You know, there's every chance that your child is not iron deficient, but this podcast is to bring awareness to how common iron deficiency is and simple strategies that we can put in place to reduce our child's risk of iron deficiency. It can be so hard to get iron into kids. Look, I really struggled. Both my kids have been low in iron at various parts of their...
childhood and I'm a pediatric dietitian, it escapes no one. I know doctors that have kids that are iron deficient, so it's not necessarily our fault or what we've done. It's just a situational issue. It's a symptom of multiple factors. Children have increased iron requirements. It's part that they need more of it for growth and development. And sometimes they really do struggle to get their requirements in through their diet. And there's other factors like...
Well, we'll talk about it in a sec, but that will definitely influence their absorption. Often children like the white, crunchy, sweet, salty foods. And most of these are very low in iron and most of these will displace iron -rich, nutritious foods that our children should be eating to meet their requirements. So if they're coming home from school, and look, I remember I was totally guilty of this. I'd come home from school.
I opened Mum and Dad's pantry and Mum had it stocked full of delicious things and I would have muesli bars and crackers and kids these days are no different, but those foods are not iron -rich foods. And again, it's displacing those iron -rich foods. So that's one reason why our children aren't getting as much iron these days. They're not coming home and eating iron -rich foods. Often those packaged carbohydrate foods are very low in iron usually and often laden with salt and sugar and...
They're a fast sugar. And anyway, that's all in other podcasts, but it's, it's one factor contributing to why our children may not be getting the iron from their diet that they need.
Children who don't eat meat (09:33.518)
Another factor is that, yeah, as I said, kids do struggle with meat. And I know that I struggled with this with my daughter. Some families choose to bring their children up vegetarian or vegan. And I totally respect that. That's 100 % fine. It's just that you then got to make sure that you're substituting appropriately with iron containing foods that aren't meat. So we need to make sure that meals and snacks contain these iron rich substitutes because...
When you go from a meat eating diet to a vegetarian or vegan diet, you need double the amount of the plant iron because the absorption isn't as good. And I've got all of this information for moms available, readily available in my membership. They've got access to my iron rich foods PDF and knowing exactly how many milligrams of iron your child needs per day for the various age groups. So got access to all of that, including tips on how to maximise iron absorption.
And we'll talk a bit more about that too. But another big reason why children these days are not absorbing or not getting the iron that they need and are at risk of iron deficiency is they're consuming too much dairy. Dairy will really impact on our child's iron levels for two reasons. Firstly, it builds them up. So dairy is what we call very satiating. It's got protein, it's got fat, it's got
carbohydrate is like a meal. And too much dairy will absolutely mean that children are feeling full, they're feeling satisfied, so they're not going to eat the hummus and crackers or other iron -containing foods. So again, just like those white carbohydrates, dairy products even more so are going to fuel kids up and they're going to displace those nutritious iron -rich foods that children need to meet their iron requirements.
So not only is dairy filling for kids, it also contains casein protein and calcium and dairy significantly impacts iron absorption. So if you're ever given an iron supplement from the chemist, they'll say don't have it around dairy, although they should, because dairy will impact on iron absorption. So it's more so the casein protein rather than the calcium. So plant milks with calcium aren't going to impact as much, but
Dairy and Iron Absorption in Children (12:00.814)
Definitely calcium and iron can compete for absorption to get super technical, but the main, the main issue is the protein. And so we need to be really mindful of dairy inhibiting iron absorption. So if you've got children that are having, you know, two or three cups of milk a day at the age of three, or even two, then it could increase their chances of becoming iron deficient. My recommendation that from the age of two,
Children should only be having one cup of milk per day. And this is so that we don't increase the risk of iron deficiency and so that children are able to eat more of the healthier foods that will give them iron and fibre and nutrition. From my perspective, we have been led to believe that we need more dairy than we actually do. Well, to be honest, we are the only species that consumes milk.
after weaning. So every other animal in the animal kingdom, they'll breastfeed from their mother. And when that's done, that's done. You don't continue to consume milk afterwards. We're the only species that continues to do that. And it's not even our own milk. It's another animal's milk that's made for baby cows. So it's a really interesting conversation, but I think it's...
Really important to remember that too much dairy can definitely cause dietary issues. So yes, dairy provides calcium and protein. Generally children in Australia get plenty of protein. It's the calcium that I guess we are, you know, when I was a dietitian going through uni, we're taught that, you know, you've got to have dairy products to provide calcium, but there's so many plant sources and plant milks that contain calcium.
You actually can easily get your calcium requirements without dairy. And again, that's a whole nother conversation, but basically the bottom line is just be mindful of your child's dairy intake because it will increase their risk of iron deficiency. So another factor that can impact on iron absorption is some compounds that are found in plant foods, such as phytates that are in like bran products and tannins found in tea and coffee can affect
Iron Absorption and Its Importance (14:23.566)
the uptake of that non -heme iron. But then having said that, plants are also rich in vitamin C, otherwise known as ascorbic acid, and that significantly improves the absorption of iron. So, you know, you'll see iron supplements that ferrograd C, for example, iron and vitamin C. And you should be told when you, if you are given an iron supplement to have vitamin C with it to significantly.
improve the absorption, you know, two, three -fold, even four -fold improvements in the absorption of iron is if you look in the literature is what you find. So definitely be mindful of the factors that can inhibit and also help iron absorption. Now, another factor that will definitely knock off your iron absorption or affect your iron absorption is reflux medication. So antacids and these things called proton pump inhibitors.
such as Losec and Imeprazole, Nexium, these medications will interfere with iron absorption, so it can increase risk of iron deficiency as well. Let's now move on to foods that are rich in both the heme iron, the animal iron, and the non -heme iron. So in order from highest to lowest, I have, drum roll, chicken liver.
Sardines, beef, lamb, kangaroo, seafood, chicken and pork, and then ham would be at the bottom there. So these are animal sources of iron. So you'll see there that there is sardines, there's some fish. So you'll see there that there's sardines, there's seafood. So it's not just red meat and often a good hack for ...
babies and little ones is I get parents to grate chicken liver into mashed veggies to significantly boost the iron intake of their child's day. There's a lot of other hacks as well that I took parents through, but iron fortified cereals, whether that's a baby cereal or even breakfast cereals such as wheat beaks, oats contain iron, for older children popcorn contains iron.
Boosting Child's Dietary Iron Intake (16:43.982)
There's plenty of hacks that we can use to boost our child's dietary iron intake. And often in little ones, it's about being really crafty about getting in other sources of dietary iron that are not meat, because often they do struggle with meat and I've got firsthand experience with that. So we really have to come at it from different angles and sneak in, not sneak in, but offer iron rich foods at main meals.
and snacks to really maximise their daily intake. So things that are rich in iron from the non -meat world, things like legumes, nuts, seeds, wholemeal products, whole grain products are rich in iron. Peanut butter is a good one, hummus. And when you're giving them these non -heme iron sources, that's when we want to be giving the vitamin C rich foods to maximise the absorption, you know,
three times the amount of absorption will occur when you're combining with a vitamin C rich food. And as I said, in my membership, I've got all this information for you, all these cheat sheets to download, but vitamin C rich foods can be a variety of fruits and vegetables. It could be strawberries, it could be rock balance, kiwi, tomatoes, parsley, broccoli, lemon, orange. So there's plenty of vitamin C rich foods, passion fruit that you can include with.
iron rich foods and it might even be my, which is now almost pretty famous, my black bean brownie, which is rich in iron, very rich in iron, mostly non -heme iron, actually all non -heme iron, but putting some strawberries next to the black bean brownie will significantly improve the absorption of that iron. So that, and that's a brilliant snack for kids. So being smart and savvy about pairing up the...
Iron -rich foods in snacks with vitamin C can make a significant difference. Even, you know, dry cereal that's been fortified, low sugar Cheerios have been fortified with iron. A great snack for toddlers or kids. You could even pop it in the lunchbox just to top up their daily intake of iron. So there's plenty of strategies and little hacks that we can use that really add up significantly over the day. So you're not relying on them eating a piece of steak at dinner.
Reorienting Iron Feeding for Children (19:02.094)
That's not the way that they're going to generally meet their iron requirements because that's how kids eat. They don't tend to eat a big chunk of meat at dinnertime, like perhaps some adults. So we have to reorient the way that we think. We have to change the way that we think about feeding our children these iron rich foods so that we are getting bits in throughout the day. We're maximizing the absorption and we're helping them get closer to their daily needs.
for their growth and their development and their brain development and for their energy levels so that they can live their best life because, you know, children are at risk of low iron and we just need to do what we can to help them meet their needs so that they can feel great. Okay, I'll start to wrap things up soon. So what can you do right now today to reduce your child's risk of becoming low in iron?
Well, firstly, if you have a baby, make sure you start solids by around the age of six months and start with a food that is rich in iron. And again, I can give you all that information if that's where you're at. Number two, make sure that you're limiting your child's cow's milk intake if they're over the age of two to one cup a day. Over the age of two, one cup a day.
that will meet their requirements. They're usually going to eat yogurt and cheese and everything else. So they're usually meeting their calcium requirements with one cup of milk a day. Number three, children one and up should be having at least three servings of iron rich foods per day. Whether that's fortified breakfast cereals, whether that's meats, whether that's baked beans, whether that's hummus, whether that's peanut butter, whether that's wholemeal bread, whether it's
You know, some spinach, we need to be making sure that we're putting iron rich foods into their main meals. And I believe snacks are a big one. I really utilize snacks a lot, cookies and black bean brownie to really boost up a child's daily iron intake.
Iron Supplementation for Children (21:04.622)
So number four, if you think your child is not getting enough iron day to day, they're living on white bread and jam, then you can look at getting a multivitamin or a gummy that contains a lower dose of iron. So usually they're two and a half to five milligrams of iron per chewable tablet or gummy. And look, this is safe to give a child when you haven't been advised by a healthcare professional.
I would definitely not supplement a child with an iron supplement, like a proper iron supplement, unless you've spoken to myself or a doctor, a healthcare professional that can give you professional advice about dosage because iron can be toxic. You can overdo it. It can be dangerous. Look, there's a condition called haemochromatosis where iron is very toxic to that person with that condition.
You know, and again, that's not going to be most of the population, but there is certainly sub population that are at risk of iron toxicity. And I would definitely not supplement a child with like a ferro liquid or a multifer or any of those concentrated iron supplements, unless you had professional advice. So just heed that warning, reach out. And again, this is something that I can advise on because I know what I'm talking about with the iron world. So.
Definitely those low concentrated gummies and whatnot are fine, but when you're going for that proper iron supplementation, then you need to be guided appropriately. And where I find myself really adding value to parents is how we actually get this iron supplement into a child. So say I've got, you know, a child who, or I'm working with a parent of a child who is iron deficient. So they've had their blood test, their ferritin is under 30, and that's what I would use.
I wouldn't use under 20, I would use under 30. And if they are under 30, the ferritin is under 30, then they need an iron supplement, but it's about looking at their weight, calculating the appropriate dose, and then working out how it's going to be best to give this iron supplement to the child. Because sometimes they don't take these iron, liquid iron preparations. I remember it was an absolute nightmare with my daughter. She wouldn't take the barri liquid. I used to have to try and wrap her.
Tips and Tricks (23:27.662)
P towel around her neck because she'd spit it out and then it would stain her clothes. It actually also stains your teeth if you're giving it long term. So there's other tips and tricks that I've got that aren't necessarily with the liquid version that is an easier way to get iron in. And certainly I succeeded with this with my daughter. But again, it would only be if you are actually having a blood test that shows, or if you've had a blood test, if your child's had a blood test that shows you're iron deficient.
And then you need supplementation. There's other ways that we can get it in more easily so that they are getting in the iron and they are getting what they need to correct the iron deficiency. So there you have it. There's your little iron tutorial for today. Why iron is so important for children. Why iron deficiency is very common. What we need to look out for. How we can reduce our risk of our children being iron deficient.
and the foods that we can give them to improve their dietary iron intake and what to do if you think your child is low in iron. And if you are worried, if they are showing signs of those symptoms that I mentioned, then definitely speaking to your doctor and getting a blood test is the first step. Thank you so much for being here. If you like what you hear, please make sure you subscribe to this podcast. Tell your friends.
and please leave me a review so that we can get this podcast out to more parents. Bye for now.