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Caring for Iron Deficiency Anemia in Children
When it comes to treating iron deficiency anemia, experts at Children's Health have a unique perspective. Learn about their method and more.
Featured Speaker:
Erin Butler, MD
Erin Butler, MD is a Pediatric Hematologist/Oncologist at Children’s Health and Assistant Professor at UT Southwestern. Transcription:
Caring for Iron Deficiency Anemia in Children
Caitlin Whyte (Host): Welcome. You're listening to Pediatric Insights, Advances, and Innovations With Children's Health. I'm Caitlin Whyte. When it comes to treating iron deficiency anemia, experts at Children's Health have a unique perspective. So today we are focusing on their methods as well as symptoms and prevention. Joining us today is Dr. Erin Butler, a Pediatric Hematologist and Oncologist at Children's Health and Assistant Professor at UT Southwestern. Dr. Butler, what is iron deficiency anemia?
Erin Butler, MD (Guest): So iron deficiency anemia is when you have iron deficiency, a nutritional deficiency that's common in children that then leads to anemia because of the decreased production of the protein hemoglobin. Hemoglobin is what's really important for red blood cells to actually bind oxygen and take oxygen around the body. And when you don't have enough iron, your body can't make enough of the hemoglobin protein.
Host: So you touched on it a bit right there, but how does iron deficiency anemia happen?
Dr. Butler: The most common nutritional deficiency that we actually see in children, both in pediatric little kids, so in our toddler patient population and also in our young adults, and it usually happens because of inadequate intake, but sometimes it can happen because children have a malabsorption issue or they have heavy bleeding, other medical causes that can result in decreased absorption of iron and increased blood loss.
Host: And what are some of the symptoms we can keep an eye out for in our children?
Dr. Butler: So for really young kids, it can be very subtle. Most kids who are toddler age have lots of energy. And so it's really hard to pick up on things like fatigue or whether or not they're short of breath. Those are symptoms that we normally see in our older patients or in patients that are young adults or adults, but for little kids, one of the most notable symptoms will be that they become very pale and they actually start to eat unusual foods. So commonly what we'll see are kids that have very long standing iron deficiency, and the parent comes in with a history of him wanting to eat ice or pencil ends or dirt. And that's actually a symptom of anemia called PICA.
Host: So when it comes to treatment, how can we treat iron deficiency, anemia? And why is treatment important?
Dr. Butler: So iron is actually really important for making red blood cells, but it's also incredibly important for bone growth, muscle growth, and also brain development. We see that in our little kids, if they're iron deficient for a long period of time, that potentially they'll have some mild developmental delays. And we know that in our older patients, so in our teenagers, we'll see that if they have iron deficiency, they may have some decreased concentrations and difficulties sleeping at night.
Some patients even have things like restless leg. So it's really important that we treat iron deficiency, not just for the anemia. The treatment is actually really easy. One of them is changing the diet, making sure that, especially in our little kids, they're not getting too much cow's milk, which can interfere with iron absorption and can cause some inflammation in the intestines and making sure that they're getting a nice, healthy diet that has lots of natural sources of iron, including red meats and other types of proteins like lentils and beans and lots of fresh fruits and vegetables, especially. If we really think the child has severe iron deficiency anemia, we can also do supplementation. We usually do supplementation as little as one time a day or even every other day. And that's enough over the course of a couple of months to bring up the iron stores.
Host: What about prevention? How can we prevent this type of anemia?
Dr. Butler: In little kids, making sure that they have some type of iron fortification is really important. So if you have a baby that you're breastfeeding exclusively, making sure that they're getting iron fortified cereal. Some patients even need to have some iron supplementation in infancy, and then making sure that as they do transition to a regular diet, that they're not getting more than that 24 ounces of cow's milk in a day.
Like I said, cows milk can interfere with that iron absorption. So, you want to make sure that they're not drinking too much milk throughout the course of the day. That's one good way to prevent it. And then in our older patients, again, just watching teenagers and making sure that they're getting a nice, healthy diet.
Host: And wrapping up here, when should you refer to a hematologist for iron deficiency anemia?
Dr. Butler: So, like I said, this is the most common nutritional deficiency that we see in our pediatric population. Most of the time, you're going to be able to treat iron deficiency without needing the hematologist. Usually when we think a hematology visit is warranted is when you do have a long-standing iron deficiency. So you've tried oral iron supplementation for three months and nothing seems to be getting better. If there's a history of any blood disorders in the family or any chronic anemias in the family, usually a visit with the hematologist is warranted to make sure that you don't have a hemoglobinopathy that has never been detected.
And then obviously if there's other symptoms like weight loss or other concerning symptoms, the hematologist should be involved to make sure that there's no absorption difficulties.
Host: Well, Dr. Butler, thank you so much for these tips and things to look out for to prevent iron deficiency anemia in our children. And as always thank you for listening to Pediatric Insights. For more information, head over to children's. com/ccbd. I'm your host, Caitlin Whyte. Stay well.
Caring for Iron Deficiency Anemia in Children
Caitlin Whyte (Host): Welcome. You're listening to Pediatric Insights, Advances, and Innovations With Children's Health. I'm Caitlin Whyte. When it comes to treating iron deficiency anemia, experts at Children's Health have a unique perspective. So today we are focusing on their methods as well as symptoms and prevention. Joining us today is Dr. Erin Butler, a Pediatric Hematologist and Oncologist at Children's Health and Assistant Professor at UT Southwestern. Dr. Butler, what is iron deficiency anemia?
Erin Butler, MD (Guest): So iron deficiency anemia is when you have iron deficiency, a nutritional deficiency that's common in children that then leads to anemia because of the decreased production of the protein hemoglobin. Hemoglobin is what's really important for red blood cells to actually bind oxygen and take oxygen around the body. And when you don't have enough iron, your body can't make enough of the hemoglobin protein.
Host: So you touched on it a bit right there, but how does iron deficiency anemia happen?
Dr. Butler: The most common nutritional deficiency that we actually see in children, both in pediatric little kids, so in our toddler patient population and also in our young adults, and it usually happens because of inadequate intake, but sometimes it can happen because children have a malabsorption issue or they have heavy bleeding, other medical causes that can result in decreased absorption of iron and increased blood loss.
Host: And what are some of the symptoms we can keep an eye out for in our children?
Dr. Butler: So for really young kids, it can be very subtle. Most kids who are toddler age have lots of energy. And so it's really hard to pick up on things like fatigue or whether or not they're short of breath. Those are symptoms that we normally see in our older patients or in patients that are young adults or adults, but for little kids, one of the most notable symptoms will be that they become very pale and they actually start to eat unusual foods. So commonly what we'll see are kids that have very long standing iron deficiency, and the parent comes in with a history of him wanting to eat ice or pencil ends or dirt. And that's actually a symptom of anemia called PICA.
Host: So when it comes to treatment, how can we treat iron deficiency, anemia? And why is treatment important?
Dr. Butler: So iron is actually really important for making red blood cells, but it's also incredibly important for bone growth, muscle growth, and also brain development. We see that in our little kids, if they're iron deficient for a long period of time, that potentially they'll have some mild developmental delays. And we know that in our older patients, so in our teenagers, we'll see that if they have iron deficiency, they may have some decreased concentrations and difficulties sleeping at night.
Some patients even have things like restless leg. So it's really important that we treat iron deficiency, not just for the anemia. The treatment is actually really easy. One of them is changing the diet, making sure that, especially in our little kids, they're not getting too much cow's milk, which can interfere with iron absorption and can cause some inflammation in the intestines and making sure that they're getting a nice, healthy diet that has lots of natural sources of iron, including red meats and other types of proteins like lentils and beans and lots of fresh fruits and vegetables, especially. If we really think the child has severe iron deficiency anemia, we can also do supplementation. We usually do supplementation as little as one time a day or even every other day. And that's enough over the course of a couple of months to bring up the iron stores.
Host: What about prevention? How can we prevent this type of anemia?
Dr. Butler: In little kids, making sure that they have some type of iron fortification is really important. So if you have a baby that you're breastfeeding exclusively, making sure that they're getting iron fortified cereal. Some patients even need to have some iron supplementation in infancy, and then making sure that as they do transition to a regular diet, that they're not getting more than that 24 ounces of cow's milk in a day.
Like I said, cows milk can interfere with that iron absorption. So, you want to make sure that they're not drinking too much milk throughout the course of the day. That's one good way to prevent it. And then in our older patients, again, just watching teenagers and making sure that they're getting a nice, healthy diet.
Host: And wrapping up here, when should you refer to a hematologist for iron deficiency anemia?
Dr. Butler: So, like I said, this is the most common nutritional deficiency that we see in our pediatric population. Most of the time, you're going to be able to treat iron deficiency without needing the hematologist. Usually when we think a hematology visit is warranted is when you do have a long-standing iron deficiency. So you've tried oral iron supplementation for three months and nothing seems to be getting better. If there's a history of any blood disorders in the family or any chronic anemias in the family, usually a visit with the hematologist is warranted to make sure that you don't have a hemoglobinopathy that has never been detected.
And then obviously if there's other symptoms like weight loss or other concerning symptoms, the hematologist should be involved to make sure that there's no absorption difficulties.
Host: Well, Dr. Butler, thank you so much for these tips and things to look out for to prevent iron deficiency anemia in our children. And as always thank you for listening to Pediatric Insights. For more information, head over to children's. com/ccbd. I'm your host, Caitlin Whyte. Stay well.