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Iron Supplements For Children: Types, Safety, Dosage And Precautions

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Iron is an integral part of hemoglobin (part of red blood cells), which helps carry oxygen across the body. If a child has low iron levels, it decreases the hemoglobin level and causes iron-deficiency anemia, which may, in turn, impact their growth and development (1).

There are several reasons for iron deficiency. It is crucial to give your child iron-rich foods to prevent iron deficiency. But, if the iron levels fail to meet the requirements, iron supplements are an effective approach.

Read on to know more about iron supplements for kids, their dosage, side effects, and precautions to be taken.

Does A Child Need An Iron Supplement?

Children on a healthy and balanced diet usually receive adequate iron. Supplements are needed if they are deficient in it. Here are a few causes and factors that may lead to iron deficiency in children (2) (3) (4).

  • Decreased absorption of nutrients due to gastrointestinal disturbances or chronic diseases
  • Exposure to lead
  • Drinking more cow’s milk as the high casein content may reduce the absorption of non-heme iron
  • Rapid growth

Are Iron Supplements Safe For Children?

Unprescribed and unnecessary iron supplementation is neither safe nor recommended for children. Excess iron could build up in the body, leading to toxicity. An elemental iron level of more than 20mg/kg could be toxic for a child (5). Elemental iron is the iron available in the supplement for the body’s absorption. Therefore, the right dosage of elemental iron in a supplement is important. This is why taking a prescription from a doctor is important before administering iron supplements to children.

What Are The Types Of Iron Supplements For Children?

Iron dietary supplements can be classified based on the chemical compound and the formulation.

1. Based on the chemical compound

There are three iron supplements based on the elemental iron percentage by weight (6).

  • Ferrous fumarate has 33% elemental iron
  • Ferrous sulfate has 20% elemental iron
  • Ferrous gluconate is 12% elemental iron

2. Based on the formulation

  1. Syrups: They are the most common type of oral iron supplementation for children. You may measure the syrups with a measurement cup, which usually comes with the supplement’s container or bottle.
  1. Chewable tablets: A chewable tablet is the easiest and the most convenient way to supplement iron to a child. They are available in many natural fruit flavors.
  1. Liquid drops: These are similar to syrups but come with a dropper. The dropper has markings to measure the dosage.
  1. Gummies: Children may enjoy supplements in this form as they come in fruity flavors and feel like candy. However, gummies may contain added sugar.
  1. Tablets: These may not be a convenient choice for young children. Nevertheless, if your child is used to swallowing pills, this option can be considered.
  1. Powders: These come in pre-measured sachets. You may add the powder to the child’s favorite foods or stir in water and serve.

Several iron supplements may also contain other nutrients such as vitamins and minerals. You must check the quantity of each nutrient to ensure your child receives adequate iron and not more of another nutrient.

What Is The Dosage?

The elemental iron in a supplement varies from brand to brand. An iron supplement should be given to a child as per a doctor’s prescription. The doctor also decides the dosage based on the child’s iron deficiency levels.

Below are the iron requirements for children depending on their age (1) (7).

Age (years)Amount of iron per day (recommended daily allowance)
1 to 3 years7mg
4 to 8 years10mg
9 to 13 years8mg

Source: Dietary Reference Intakes; Government of Canada

Most oral iron supplements offer 33mg to 65mg of elemental iron. A dosage of more than 20mg/kg could result in mild toxicity. Anything more than 60mg/kg may most likely cause severe toxicity. Therefore, it is essential to provide iron supplements after consulting a doctor, who can modulate the dosage based on the child’s weight and other factors.

What Are The Side Effects?

The side effects of iron supplementations can be avoided when taken as per the prescribed dosage. Overdose of iron supplements in children may cause the following side effects (8) (9).

  • Diarrhea
  • Fatigue
  • Vomiting
  • Chest pain
  • Black stools
  • Constipation

If you observe any of the above symptoms after iron supplementation, restrict its intake and contact your medical advisor.

What Are The Precautions To Be Taken?

The following precautions could help in the safe dosage of iron supplements in children (9).

  • Administer iron supplements to a child only when prescribed by a doctor.
  • Maintain the prescribed dosage of supplementation.
  • Keep supplements away from a child’s reach to avoid overdose.
  • Iron is best absorbed on an empty stomach. If your child experiences abdominal discomfort, then pair the iron supplement with food.
  • Give iron supplements with foods rich in vitamin C, such as lemon or orange juice, as this boosts the rate of iron absorption.
  • Avoid giving iron supplements with milk, high-fiber foods, or caffeinated beverages as they may hinder the absorption of iron.

Iron supplements for children are often prescribed in cases of severe iron deficiency. The supplementation dosage could change as the child grows older or if they show improvements in iron deficiency. Ensure your child continues to eat a well-balanced diet rich in iron since food will be the long-term source of iron for your child’s healthy growth and development.

References:

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Sindusha MS

Sindusha is a clinical nutritionist with over two years of experience in diverse fields of nutrition. She did her Masters in Food Science and Nutrition and has qualified UGC-NET. She interned as a quality control analyst and as a dietitian during her graduation. She was a part of several community nutrition projects and a phytochemical-based nutrition study during the same... more