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The most common reason for iron deficiency anemia in infants and children is the inadequate supply of iron in the diet. Iron is a mineral the body needs in order to make red blood cells. Children go through periods of rapid growth and the diet should supply enough to facilitate the increased need for more red blood cells. There are other times when children may acquire this anemia. The infant may have been given low or non-iron fortified formula or breast fed through the later months without supplementation of iron. This occurs in premature infants or low birth weight infants. Other times the infant or child may have a gastrointestinal disease such as a chronic infection, chronic diarrhea, coeliac disease or an intestinal parasite. But the most common in infants, children and adolescents, is the low intake of iron in the diet. More specifically:
· Breast feeding exclusively after six months of age
· The introduction of cow's milk before twelve months of age or over reliance
· Introducing solid foods later that six months of age
· Lack of meat in the diet
· Inadequate food intake

In the first 6 months of age, iron stores are dependent on what has occurred during pregnancy. Due to the possible low stores of iron during pregnancy, low birth weight or premature infants are particularly vulnerable. The following six to twelve months iron deficiency can be brought on by poor feeding practices. For the toddlers and preschoolers, energy and iron demands for growth continue to be very high. At this age prolonged exclusive breast-feeding, the delayed introduction of foods or the over dependence on cow’s milk may bring on anemia. Adolescents are particularly at risk because of the growth spurts during puberty and poor eating habits. This is true particularly in girls.

The major changes that occur are behavioral, cognitive and psychomotor deficits and decreased immune function. Behaviors such as lethargy, irritability, and the inability to concentrate are symptoms. These symptoms are followed by psychomotor and cognitive impaired skills. This causes shortened attention span and may impair learning. Even the slightest case of iron deficiency anemia, before noticeable symptoms, can slow cognitive development. Some evidence also shows that iron deficiency anemia leads to decreased immune functions. Children that have recurrent infections should be tested for anemia. The symptoms of severe or prolonged anemia are failure to thrive, swollen tongue, spoon-shaped brittle nails and splits or sores in the corners of the mouth. The severest case can cause heart failure.

The treatment is dietary. Emphasis on iron rich food sources is most important in prevention and treatment. Good sources of iron are:
· Best sources: breast milk, formula with iron, iron fortified cereals, liver, prune juice
· Good sources: eggs, meat, fish, chicken turkey, soybeans peanut butter, dried beans, lintils, molasses, peas
· Other: tuna, oatmeal, apricots, raisins, kale, prunes, greens

Taking vitamin C can facilitate iron absorption from other sources. Cooking in iron pans can help by adding iron to foods. For picky eaters, a vitamin supplement that includes iron may be needed. However, if the diet is rich in iron and is well balanced there is no need for supplementation. Unnecessary inhibitors of absorption of iron should be avoided, such as those in tea, coffee and fiber. Finally, drinking too much milk can make anemia worse. Drinking more than 32oz. per day can cause iron loss through intestinal walls, as well as, making it more difficult to use the iron that has been stored in the body.