The body needs iron in order to make hemoglobin, an iron-containing protein in the red blood cells (RBCs). Hemoglobin helps your blood carry oxygen and deliver it to all of your other cells. Without hemoglobin, the body will stop producing healthy RBCs. Without enough iron, your child’s muscles, tissues, and cells won’t get the oxygen they need.
Breast-fed babies have their own iron stores and usually get enough iron from their mother’s milk for the first 6 months, while bottle-fed infants typically receive a formula fortified with iron. But when your older infant switches to eating more solid foods, they might not be eating enough iron-rich foods. This puts them at risk for iron-deficiency anemia.
Iron deficiency can hamper your child’s growth. It may also cause:
- learning and behavioral issues
- social withdrawal
- delayed motor skills
- muscle weakness
Iron is also important for the immune system, so not getting enough iron may lead to more infections, more colds, and more bouts of the flu.
Does My Child Need an Iron Supplement?
Kids should get their iron and other vitamins from a balanced, healthy diet. They most likely won’t need a supplement if they eat enough iron-rich foods. Examples of foods high in iron include:
- red meats, including beef, organ meats, and liver
- turkey, pork, and chicken
- fortified cereals, including oatmeal
- dark green leafy vegetables like kale, broccoli, and spinach
Some children are at a higher risk of iron deficiency and may need to take a supplement. The following circumstances could put your child at higher risk for an iron deficiency:
- picky eaters who aren’t eating regular, well-balanced meals
- children eating a mostly vegetarian or vegan diet
- medical conditions that prevent the absorption of nutrients, including intestinal diseases and chronic infections
- low birth weight and premature infants
- children born to mothers who were deficient in iron
- kids who drink too much cow’s milk
- exposure to lead
- young athletes who exercise often
- older children and young teenagers going through rapid growth during puberty
- adolescent girls who lose blood during menstruation
Asking Your Doctor About Iron Supplements
Don’t give your child iron supplements without first talking to your doctor. Checking for anemia should be part of your child’s regular health exam, but ask your doctor if you have any concerns.
Your pediatrician will conduct a physical examination of your child and ask if they are showing any of the signs of an iron deficiency, including:
- behavioral problems
- loss of appetite
- increased sweating
- strange cravings (pica) like eating dirt
- failure to grow at the expected rate
Your doctor might also take a small sample of blood to check your child’s red blood cells. If your doctor thinks your child has an iron deficiency, they may prescribe a supplement.
How Much Iron Does My Child Need?
Iron is a very important nutrient for a rapidly growing toddler. The recommended daily requirements for iron vary by age:
- ages 1 to 3 years: 7 milligrams per day
- ages 4 to 8 years: 10 milligrams per day
Too much iron can be toxic. Children under age 14 shouldn’t take more than 40 milligrams a day.
5 Safe Types of Iron Supplements for Kids
Iron supplements for adults contain far too much iron to give them safely to your child (up to 100 mg in one tablet).
There are supplements available in tablets or liquid formulations that are made specifically for young children. Under your doctor’s supervision, try the following safe supplements:
1. Liquid Drops
Liquid supplements work well because the body can absorb them easily. Your child won’t have to swallow a pill. The bottle typically comes with a dropper with markings on the dropper tube to indicate the dosage level. You can squirt the liquid straight into your child’s mouth. Iron supplements can stain your child’s teeth, so brush their teeth after giving any liquid iron supplement.
Try a liquid supplement like NovaFerrum Pediatric Liquid Iron Supplement Drops. It’s free of sugar and naturally flavored with raspberry and grape.
You can safely measure out and give your child a spoonful of their iron supplement with syrup. Pediakid Iron + Vitamin B Complex, for example, is flavored with banana concentrate to make it taste better for your kid. Two teaspoons contain about 7 milligrams of iron. However, it also contains many other ingredients your child may not need, so it is not the best choice if you are looking for just an iron supplement.
If you don’t want to deal with measuring out liquids and syrups, a chewable supplement is the way to go. They're sweet and easy to eat and typically contain many vitamins in the same tablet. The Maxi Health Chewable Kiddievite is specially formulated for children and comes in a kid-friendly bubblegum flavor. Note, however, that these vitamins have a relatively low dose of iron compared to their other ingredients. Just remember to keep the bottle locked away and out of the reach of your children.
Kids love fruity gummies because of their taste and resemblance to candy. While it is perfectly safe to give your kid a vitamin gummy, parents must be extra cautious to keep them out of the reach of children at all times.
The Vitamin Friends Iron Supplement gummies are vegetarian (gelatin-free) and don’t contain any artificial flavors or colors. They are also free of eggs, dairy, nuts, and gluten. Though you might have to take extra precautions to keep these out of the reach of your children, your kids will take them with no fuss and won’t ever complain about the taste.
A powder iron supplement can be mixed with your kid’s favorite soft foods, such as oatmeal, applesauce, or yogurt, so picky eaters might not even know they are eating it.
The Rainbow Light NutriStart Multivitamin with Iron is free from artificial dyes, sweeteners, gluten, and all common allergens. It comes in packets measured to the correct dosage for your kid. Each packet contains 4 milligrams of iron.
What Are the Side Effects of Iron Supplements?
Iron supplements may cause upset stomach, stool changes, and constipation. They absorb better if they’re taken on an empty stomach before a meal. But if they upset your kid’s stomach, taking it after a meal instead may help.
Excessive iron intake can lead to serious health problems so never give your child iron supplements without first consulting a doctor. According to the NIH, between 1983 and 1991, the accidental ingestion of iron supplements caused almost a third of accidental poisoning deaths in children in the United States.
Signs of an iron overdose include:
- severe vomiting
- pale or bluish skin and fingernails
An iron overdose is a medical emergency. Call poison control immediately if you think your child has overdosed on iron. You can call the National Poison Control Center (1-800-222-1222) from anywhere in the United States.
What Precautions Should I Follow?
When giving your child a supplement, follow these precautions to make sure your child is safe:
- Follow all of your doctor’s instructions and if you’re not sure about something, give your pediatrician a call.
- Make sure all supplements are out of the reach of children so they don't mistake them for candy. Put the supplements on the highest shelf, preferably in a locked cupboard.
- Make sure the supplement is labeled in a container with a child-resistant lid.
- Avoid giving your child iron with milk or caffeinated drinks because these will prevent the iron from being absorbed.
- Give your kid a source of vitamin C, like orange juice or strawberries, with their iron, as vitamin C helps the body absorb iron.
- Have your child take the supplements for as long as your doctor recommends. It may take more than six months to get their iron levels back up to normal.
There are many types of supplements available for your kids, but don’t forget that they’ll need iron for the rest of their lives. Start introducing iron-rich foods as soon as possible. Fortified breakfast cereals, lean meats, and lots of fruits and vegetables are a good way to start.
How can I tell if my child has an iron deficiency?
An iron deficiency is the most common cause of anemia (low red blood cells or hemoglobin) in children. A medical and dietary history and sometimes a simple blood test for anemia is usually all that your doctor needs to do to make a diagnosis. More specific blood tests for iron levels can be done in cases where the cause of anemia is not clear or is not improving with iron supplementation. The physical and behavioral signs of iron deficiency are usually only apparent if the anemia is severe and/or long-standing.Karen Gill, MD, FAAPAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Are supplements or iron-rich foods the way to go?
Iron-rich foods are the best way to prevent iron deficiency for most healthy children. Iron supplements prescribed by your child’s doctor are needed if your child is diagnosed with anemia caused by iron deficiency.Karen Gill, MD, FAAP Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.