What You Need to Know About Kids and Iron


What is anemia?

Anemia by definition is an iron deficiency. Iron is a trace metal found in the environment, including some food sources, and is absorbed by the intestine when consumed. A healthy gut is essential to absorbing the vitamins, minerals, and trace metals necessary for doing life. (See our blog on probiotics for how to help augment a healthy intestine for yourself and your family.)

Red blood cells need hemoglobin in order to carry oxygen to the body. Each hemoglobin needs four atoms of iron to bind to a molecule of oxygen. Without enough iron, the body doesn’t have enough hemoglobin, and the blood isn't able to transport enough oxygen to keep the body systems functioning properly. Low iron makes activities of daily living increasingly difficult. For example, a child with low iron may be fatigued, unable to think, play, or do life well.

How do I know if my child is anemic?

At Hopewell Family Care, we check iron levels at every wellness exam, starting at 1 year of age. Acute anemia occurs in 1 out of every 2 of the children we see. Childhood anemia, if not corrected, can become chronic adult anemia, which is more difficult to correct and contributes to greater health problems. We do an in-office toe prick to measure the amount of hemoglobin in the blood (the majority of children hardly notice). A reading of less than 11.5 is indicative of low iron. Age and gender are also taken into consideration when determining whether or not iron levels are low.

How did my child become anemic?

In addition to what the iron level is, it’s important to know the reason why a level is what it is. Is the child not getting enough iron-rich nutrients? If your child is anything like mine, they beg for crackers and empty nutrients rather than a large plate of kale. Is the child’s intestine unable to absorb the iron its receiving? Some children have issues of gut absorption, which requires more attention than simply supplementing with iron. If the intestine is inflamed, it won’t absorb iron (or other nutrients), no matter how much iron-rich foods are consumed. The gut needs healed for supplementation to be effective. Has the child’s iron been too low for too long? The body works on a negative feedback system. If iron levels get too low, the body forgets to absorb it. With supplementation, the body can be reminded to do its job again.

What are some iron treatments that we recommend?

Iron-rich foods. High doses of iron-rich foods, such as almonds, blackstrap molasses, spinach, kale, and organ meats are important to help increase iron levels. For children, I make a green smoothie and molasses cookies to help them get more of the iron they need (see recipes below). I have also successfully introduced kale chips! I recommend eating a handful of strawberries, a clementine, or a chewable Vitamin C tablet after an iron-rich meal, as Vitamin C assists in the absorption of iron and other nutrients.

*Floradix. Because many children are picky eaters, a daily supplement approach is often more successful. Floradix is a plant-based iron supplement that has a weight-based dose. It can be taken on its own or added to a smoothie or other drink. If masking it with another drink, mix it with a small amount to ensure that the child gets all of the iron in the dose. It’s important to determine the dosage with your pediatrician and schedule iron rechecks before continuing supplementation, as self-treating can cause iron overload, which presents with other side effects.

*Chlorophyll. Some sources recommend chlorophyll drops. They are added to water and give a minty taste. However, there is no child’s dose in any literature, so its use is more or less trial and error until iron levels increase. As it is under-researched, use chlorophyll with caution.

*Iron Fish. We understand that the inconsistencies of life can make consistency with iron treatment difficult. We recommend using an Iron Fish, which can help meet 90 percent of daily iron needs. To use, cook with the Iron Fish regularly in stir fry, boiling water for soup or oatmeal, or anything else on the stovetop (do not use in microwaves). Supplementing iron in this way increases iron intake for the whole family rather than one child at a time. For more information, visit www.luckyironfish.com.

[*We carry Floradix, Chlorophyll, and the Iron Fish in our office for your convenience.]

I typically see adequate improvement in my pediatric patients’ iron levels after three to six months of supplementation. The key to effective iron treatment is consistency. Whatever you do, do it as regularly as possible in order to get the results you want, and your child’s body needs.

Jaimeé Arroyo Novak, FNP

Green Smoothie

½ pineapple
3 clementines
2 tbsp blackstrap molasses or local honey
4 cups spinach

Blend together with preferred amount of ice

Molasses Cookies

1 ½ cups blanched almond flour
¼ tsp sea salt
¼ tsp baking soda
1 tsp ginger
½ tsp ground cinnamon
¼ cup grapeseed oil or palm shortening
¼ cup blackstrap molasses

Combine dry ingredients in a large bowl
Combine wet ingredients in a small bowl
Mix wet ingredients into dry ingredients
Scoop onto baking sheets lined with parchment paper 1 tablespoon at a time, gently press
Bake at 350° for 6-10 minutes
Cool and serve