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Iron-Deficiency Anaemia 147
Most harmful are sweet and acidic drinks given in ●● developmental delay
a bottle which is left with the child to suck as they
fall asleep and during the night. This is also a ●● poor educational achievement
choking risk.
●● breath holding
Iron-Deficiency Anaemia
●● swallowing difficulty with food sticking
Between 10 and 11 per cent of all preschool children (pharyngeal web)
in the UK and up to one-third of Asian toddlers are
thought to be iron deficient (Moy 2006). It is not ●● pica (e.g. licking newspapers, eating soil, carpet
unique to any population although its incidence underlay, wood, etc.).
tends to be higher in inner city areas and among
Asian populations (Lawson et al. 1998). To correct iron deficiency an iron supplement may
be prescribed, but for the long term a diet as
Diagnosis of iron-deficiency anaemia is based discussed above with the appropriate number of
on blood tests. The World Health Organization servings of foods from food groups 1–4 will prevent
definition of iron-deficiency anaemia is a iron deficiency.
haemoglobin of <11.0 g/dL. Low plasma ferritin
levels indicate very low stores of iron. Maintaining iron stores and preventing
deficiency in children 1–4 years old can be
An iron supplementation is usually prescribed promoted by:
to correct anaemia.
●● advising against the change to cow’s milk as the
A poor diet is by far the most common cause of main milk drink before 12 months of age and
iron-deficiency anaemia in children 1–4 years old. then restricting it to 360 mL/day or less if the
The dietary risk factors are: toddler is eating yogurt and cheese
●● late weaning or inappropriate weaning foods ●● encouraging consumption of iron-rich foods
during infancy (e.g. red meat, oily fish, eggs, iron-fortified
breakfast cereals, beans and pulses, nuts, dark
●● changing to cow’s milk as their main drink green vegetables and dried fruit). (NB: Liver is a
before 12 months of age good source but should be limited to once per
week as it has a high vitamin A content.)
●● consuming excessive amounts of cow’s milk –
frequently from a bottle (an excess is more than ●● giving vitamin C-rich fruit and vegetables with
600 mL per day) meals as this promotes iron absorption, for
example, citrus fruit, tomatoes, peppers, kiwi
●● eating an unbalanced diet with excess milk, fruit, strawberries and potatoes
confectionery, or low-nutrient snack foods and
eating too few high-iron foods. ●● advising against giving tea as a drink with meals
and snacks as it contains tannin, which
Iron deficiency may cause: decreases the absorption of iron from food
(Booth and Aubett 1997).
●● pallor, spoon-shaped nails (koilonychia), sores
at the corner of the mouth (angular stomatitis), Parents who have trouble reducing an excess cow’s
a sore tongue (glossitis) milk intake in their young child could consider
changing from cow’s milk to an iron-fortified
●● tiredness, irritability formula such as a follow-on formula or a
growing-up milk. However, the ultimate aim
●● poor appetite should be to cut down milk consumption so that
more iron-rich foods will be eaten.
●● reduced exercise tolerance
●● increased risk of infection
