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When is your child at risk of anaemia, and why?

50% of two-year-olds in Ireland are iron deficient, and nearly 10% suffer from iron-deficiency anaemia.

It’s a serious problem, as iron deficiency can stunt the development of children less than two years of age. Studies also show that the damaging effects of having anaemia this young may not be reversible even with iron supplements given later on.

When is my baby at risk, and why?

It’s interesting to note that the number of iron-deficient children rises between the ages of one and two, from 23% to 50% It’s very likely that the early introduction of cows’ milk is contributing to this dramatic change.

Some mums are swapping breastmilk and formula based drinks for cow’s milk based drinks too early. This is creating iron deficiencies in two ways. Firstly the cow’s milk does not have enough iron content on its own. Secondly, the replacement of solid foods with cow’s milk based drinks means the baby is also failing to receive the iron it could otherwise obtain from solid food. Iron deficiency anaemia causes developmental and learning problems in children.

What are the symptoms of anaemia?

The usual symptoms of anaemia are;

• Lack of concentration.
• A lack of general activity and playfulness.
• Poor appetite.
• Paleness.
• Tiredness.

What should I do if I think my baby is anaemic?

If you suspect that your baby is anaemic you should talk to your public health nurse or GP, who may carry out blood tests to make an accurate diagnosis.

How is iron-deficiency anaemia diagnosed?

Blood tests

Blood tests are taken to assess haemoglobin levels. A low haemoglobin level indicates anaemia.

Blood film

A blood film may be used to assess the size and shape of red blood cells. This test is performed by smearing a small amount of blood on a slide and looking at it under a microscope.

In iron deficiency anaemia, the red blood cells are smaller than usual and their colour is lighter. Some of the cells may also have an abnormal shape.

Other tests

The serum iron and the iron binding capacity of protein in the blood may also be tested. Ferritin is the molecule in the body that stores iron, and existing levels in the blood may be tested for. This set of tests will reveal whether the problem lies in the body’s ability to deal with iron retention and absorption.

Will iron supplements be recommended?

It’s crucial that the underlying cause of the iron deficiency is treated, as anaemia can lead to long term damage. Ideally, babies should get all the iron they need from a balanced diet although iron supplements may be necessary to return the haemoglobin to normal, replenish serum iron, and iron stores.

Follow-on milks which contain extra iron, such as Aptamil Follow-On can significantly contribute to your baby’s iron stores and can complement a balanced diet

What can I do to prevent iron deficiencies from happening?

A nine to twelve month old should have 7.8mg of iron per day. But how much food or milk contains this amount of iron?

• Two tablespoons of stewed mince contains 1.1mg of iron.
• One size 3 egg contains1.0 mg of iron.
• One pint of Aptamil Follow-on Milk contains 5.6g of iron.
• One pint of cows’ milk contains 0.2mg of iron.

Cows’ milk is not recommended as a main milk drink before one year because it is too low in iron. Breastmilk or infant milk formula are the only recommended milk drinks for babies in their first year.

Ensure that your baby is also eating plenty of solid foods with good iron content such as liver, beef, chicken, eggs, pork and dark green vegetables such as broccoli.

What kind of solid foods would a baby of this age be eating that contain iron?

Breastmilk provides a good source of iron that is easily absorbed. Lean red meat, eggs, fortified breakfast cereal, wholemeal bread, broccoli, prunes and apricots are also good iron sources.

The iron from these vegetable foods is best absorbed when they are eaten with a vitamin C rich food; vitamin C can double or even triple iron absorption, so it’s a good idea to give your baby some orange juice with an iron fortified breakfast cereal to ensure he’s absorbing as much iron from his diet as possible.

Other foods rich in vitamin C you can include in your baby’s diet include citrus fruits such as oranges, lemons, limes and grapefruit and the juices made from them. Potatoes, tomatoes, strawberries, blackberries and blackcurrants are also excellent sources of vitamin C.