Many parents are worried that their children are not getting enough nutrients. Iron is a nutrient that is often mentioned and there can be a lot of confusion regarding its best sources and absorbability. In this article we’ll clarify why iron is important in our children’s diet, what factors improve its absorbability and which foods are good sources of this important mineral. I am also including an exemplary meal plan for a child at the end of the article.
The function of iron in the body
Iron is a well-known mineral and is found in every cell of the body, almost all of it combined with protein. Hemoglobin, a molecule that carries oxygen throughout our body, contains 60% to 70% of the body’s iron. Hemoglobin, and therefore iron, gives us our children strength and the look of good health (that is, their rosy cheeks). This makes iron an important component in transporting oxygen to our tissues.
Its importance for growing children
Iron is a nutrient that is essential to a child’s growth and development. When there is not enough iron, red blood cells become small and pale. They can’t carry enough oxygen to the body’s organs and muscles. The result is a condition called anemia. Iron deficiency anemia is a well-known and all-too-common problem, even with our knowledge about the condition and the attention given to preventing it. The pre-anemia state is not easy to diagnose. Lower iron stores, as well as relative decrease in serum iron levels and protein-bound iron may cause symptoms before low tissue iron levels or anemia are measurable. Iron deficiency is more common in infancy, childhood, adolescence, and pregnancy.
How much iron does a child need per day?
Full-term babies are born with a reserve of iron, which comes from their mother’s blood while they are in the womb. For the first six months, breastfed babies will get what they need from their mother’s milk. If breastfeeding is not an option, then it is recommended to use an iron-fortified formula for the first 12 months. The amount of iron a child needs depends on their age:
|Age||Amount of iron per day (RDA)|
|7 to 12 months||11mg|
|1 to 3 years||7 mg|
|4 to 8 years||10 mg|
|9 to 13 years||8 mg|
|14 to 18 years||11 mg (for boys) and 15mg (for girls)|
Usually, when the body needs more iron, absorption improves through an increase in iron-carrying proteins in the blood called iron transferrin.
Risk factors for iron deficiency in children
Infants and children that have a higher risk of iron deficiency include:
- Babies who are born prematurely – more than three weeks before their due date
- Babies who drink cow’s milk or goat’s milk before the age of 1
- Breast-fed babies who are not given complementary foods containing iron after age 6 months
- Babies consuming formula that is not iron-fortified
- Children ages 1-5 who drink more than 700ml of cow’s milk, goat’s milk or soy milk a day
- Children who have certain health condition, or restricted diets
Iron deficiency symptoms in children
Several studies have shown that often more than half of children aged 1 through 5 had iron intakes below the RDA. Children who are iron deficient may experience psychological problems, learning disabilities based on hyperactivity or a decreased attention span, and even a lower IQ, besides other symptoms of anemia. Headaches, dizziness, pale skin, weight loss from decreased appetite, constipation and lowered immunity are some of the symptoms of iron deficiency. In children particularly, iron deficiency may cause a strange symptom called pica – eating and sucking on inedible subjects, such as toys, clay, or ice.
Foods that contain iron
From the plant foods, whole grains are a great source of iron, because of their germ and bran. Wheat, rye, oats, brown rice all contain iron. Legumes are also a good source, especially lima beans, soybeans, kidney beans and green peas. Nuts, such as almonds and Brazil nuts, as well as most seeds contain iron as well. Pumpkin seeds are a particularly good source. Green leafy vegetables as spinach, chard, kale and dandelion are also good sources, as are broccoli and asparagus. From the dried fruits, prunes, raisins and apricots have good amount of iron. Blackstrap molasses is a concentrated source of iron – 1 tbsp contains about 3 mg. Other foods such as tomatoes, strawberries, as well as many other vegetables contain some iron, and so it is possible to obtain adequate amounts of iron without consuming a lot of meat, by eating wholesome foods.
From the animal foods, in addition to beef, liver and other organ meats have relatively high amounts of absorbable iron. Other sources include chicken, shellfish and egg yolks.
The following table shows some foods and their iron content**
|Pumpkin seeds, dried||100g||8.8|
|Blackstrap molasses||2 tbsp||7.0|
|Veggie burger, commercial||1 patty||3.0|
|Rye sourdough bread||100g||2.9|
|Lima beans, cooked||100g||2.7|
|Pinto beans, cooked||100g||2.7|
|Kidney beans, cooked||100g||2.4|
|Swiss chard, cooked||100g||2.3|
|Black beans, cooked||100g||2.1|
|Figs, dried||5 medium||2.0|
|Bok choy, cooked||100g||2.0|
|Beet greens, cooked||100g||1.9|
|Turnip greens, cooked||100g||1.75|
|Apricots, dried||10 halves||1.6|
|Soy yogurt||175 ml||1.4|
|Tomato juice||100 ml||0.6|
Heme and non-heme iron
The form of iron found in plant foods is called nonheme iron. The iron found in meat (including poultry and fish) is called heme iron. Heme iron is far more easily absorbed by the body than iron obtained by plant sources. Between 10% and 30% of heme iron is absorbed. One reason nonheme iron is difficult to absorb is the phytates present in whole grains and oxalates found in certain vegetables, which may bind up some of the iron, making it unabsorbable. Meat foods may help absorption possibly by stimulating increased stomach acid production, and by the fact that the iron contained is already bound into muscle and blood tissue in the form of the iron proteins myoglobin and hemoglobin. This however does not mean that we need to eat meats in order to get sufficient iron, even though this is often recommended in cases of iron deficiency.
How to improve iron absorption
The absorption of iron is a delicate process. Poor absorption from the intestinal tract, together with a low-iron diet, are among the main reasons that iron deficiency is so common. Average iron absorption is about 8% to 10% of intake.
Many factors can
increase iron absorption from the intestines. Iron absorption takes between
2 and 4 hours, and if you are consuming mostly plants, or are vegan or vegetarian,
combining iron-rich foods with vitamin C, will help its absorption. Vitamin C
in the gut along with iron converts any ferric iron to ferrous and thus
improves absorption. Adding citrus fruits and many vegetables that contain vitamin
C therefore help with iron absorption. Cooking with an iron skillet adds iron
to the food and makes more of it available for absorption. Protein foods also
improve iron absorption.
Absorption additionally improves when there is increased need for iron, as during growth periods, pregnancy, and lactation, or after blood loss.
It is also worth noting that some minerals like calcium compete with iron for absorption in the gut.
About 25% of the iron in the body is stored bound to the protein ferritin and as the iron complex hemosiderin. Ferritin has good iron-binding capacity. Ferritin stored in the liver, spleen, and bone marrow, for example, provides a good reserve of iron to meet body needs. Measuring serum ferritin levels provides a good indication of iron storage levels. A normal value is 15 to 200mcg. A level below 15 mcg suggests depleted iron reserves.
The body conserves iron very well, but this also increases the possibility of toxicity. Hemochromatosis is the most common genetic disorder known to occur in humans, where excessive amount of iron is stored in the body. Excessive iron stores is associated with increased rates of coronary artery disease and liver cancer. It can disrupt immune function and metabolic events almost anywhere in the body. Iron is a potent oxidant and excess amounts of it circulating in the body can cause the production of free radicals, which in turn damage the cells. Consuming non-heme iron (from plant foods) can help prevent toxicity as the body absorbs only what it needs. With heme iron (from animal foods) the body absorbs all the iron in the food, regardless of whether it is health supporting to do so. *
Should you test your child for iron deficiency?
Iron deficiency can be typically diagnosed through blood tests. You can test your child starting between ages 9 months and 12 months, and for those who have risk factors for iron deficiency, again at later stages. Depending on the results, your doctor might recommend an oral iron supplement or multivitamin. Do not give your child iron supplements without consulting your doctor first, as too much iron poses health risks as discussed above.
Meal example that will meet the daily iron requirements of a child
Porridge, consisting of:
Oats 50g = 2.1mg iron
Soy milk 100ml = 0.6mg
Almond butter 10g = 0.37mg
Hemp seeds 5g = 0.4mg
Half a banana = 0.3mg
5g raisins = 0.13mg
Total iron content in breakfast: 3.9 mg iron
Coconut and lentil stew with tofu, spinach, broccoli, peppers, tomatoes, and curry
Lentils, 30g = 0.93mg
Spinach, cooked 20g = 0.72mg
Tofu 40g = 2.16mg
Tomato sauce 30g = 0.3mg
Broccoli 15g = 0.1mg
Curry powder 1/8 tsp = 0.4mg
Total iron content in lunch: 4.61mg
Sourdough rye bread (1 slice of 50g) = 1.45mg
Hummus 15g = 0.36mg
Cherry tomatoes (for vitamin C)
Soy yogurt 100ml = 0.8mg
Ground flax seeds 2 tsp = 0.2mg
Total iron in snack: 2.81mg
Veggie burger (1 patty) = 3mg
Homemade cashew mayonnaise (16ml) = 1.1mg
Baked potato (half) = 0.7mg
Green peas (20g) = 0.2mg
Total iron content dinner = 5mg
Total iron for the day = 16.32mg iron
Staying healthy with nutrition; Elson M.Haas, MD, p.188-196
The nourishing traditions book of baby & childcare; Sally Fallon Morell p. 181-182
Healthy at 100; John Robbins, p. 149 – 152
Table, food sources of iron: USDA Nutrient Data Base for Standard Reference 465