Iron deficiency in children: the most important questions and answers

Eisenmangel bei Kindern: Die wichtigsten Fragen und Antworten

Does your child suffer from permanent tiredness, listlessness and is also much paler around the nose than usual? Then it can easily be that it suffers from iron deficiency. Don't worry, it even belongs to a large part of the world's population, which is why this deficiency disease is well known and therefore the necessary measures.

In this article you will find all the information about iron deficiency in your child. Among other things, you will find possible causes for how to recognize iron deficiency and what consequences it can have. Of course, we also show you what helps best against iron deficiency and have picked up various aspects for this.

the essentials in brief

  • Iron deficiency in children is one of the most common deficiency diseases worldwide. Among other things, iron is responsible for transporting oxygen in the body and should be treated as quickly as possible if there is a deficit.
  • Iron deficiency is mostly due to diet. Iron is primarily ingested through food, which is why attempts to compensate for iron deficiency in children are the first to be made here.
  • A permanent iron deficiency, which already develops in childhood, can result in long-term damage. Iron deficiency in children can negatively affect both cognitive and sensorimotor development as well as accurate growth.

Iron deficiency in children: what you should know

The most relevant questions about iron deficiency in children are answered below.

What causes iron deficiency in children?

Iron deficiency is the most common deficiency in humans worldwide. About half of these are then the reason for anemia, a so-called anemia. Babies and children belong to the risk group among people affected by iron deficiency. (2)

Iron is only ingested through food.

A normal Central European diet should contain enough iron. There are usually several factors working together that lead to iron deficiency in children. Most of the time, however, it is due to a lack of dietary intake or an increased need. (2)

Iron deficiency occurs in children mainly because they are in the growth phase and they develop an increased need for iron as a result. Relatively critical and requires a lot of attention is the period between half a year and 2 years in which increased iron deficiency can develop. (2)

children and food

Since iron is absorbed through food, it is important to ensure that children have a balanced diet that includes enough iron. (Image source: Kelly Sikkema / unsplash)

People who have a generally increased need for iron or children also have a higher absorption, which amounts to 10-15% in healthy children. This is the reason why it is important to have an iron-rich diet in order to avoid the onset of anemia later on. (1)

What is the daily iron requirement for children?

The daily iron requirement for children over a period of 1 to 10 years is shown below. These are reference values ​​that can also vary depending on the situation. (4)

Old mg/day
1-4 years 8th
4-7 years 8th
7-10 years 10

In childhood, no distinction is made based on gender in relation to the daily dose of iron required. It is not until early puberty that it can be seen that girls have a higher iron requirement than boys. Of course, there are special cases of iron requirements among children that cannot be covered with these values. (4)

How common is iron deficiency in children?

Iron deficiency in children often occurs independently of the living conditions in which the children grow up. Even in good socio-economic conditions, it is almost inevitable that children in particular will have low iron stores by the end of their first year. This is also the case despite iron-rich food such as meat. (1)

Iron deficiency is one of the most common deficiency diseases, especially in Europe.

Among the social groups most affected are pregnant women and women in general, including (small) children in the various stages of growth. However, there has been a decrease in the prevalence of iron deficiency disease in infants. (7)

Although iron deficiency also occurs in children who can be cared for with all the necessary precautions, the prevalence among children in poorer circumstances is significantly higher this year. Education about the nutrition required for babies and children plays a major role here, as does access to the necessary food, which is not always available. (6)

How do I know if my child is iron deficient?

If there is an iron deficiency, it affects the entire body. A number of symptoms can be identified that can be used to identify iron deficiency in children:

  1. Since the lack of iron affects the human organism, one of the most well-known symptoms is constant fatigue . Most children are known to be very active and full of life through everyday life, which is why extreme tiredness is noticed very quickly.
  2. Due to a noticeably high level of tiredness, a decrease in physical performance also sets in as a result. This has a significant impact on the children's muscular endurance and energy balance. Since enough iron is needed for growth , this too can be delayed due to a deficiency.
  3. Other physical symptoms include brittle hair and nails and torn corners of the mouth. In addition, iron deficiency leads to an unusually intense pallor of the skin. Iron deficiency in children is noticeable not only externally, but also mentally, for example with cognitively weakened performance. (3)

What are the consequences of iron deficiency?

The consequences of iron deficiency in children can take different forms. Since, as mentioned above, muscular endurance is affected by iron deficiency, this can result in a type of muscle wasting. The deficiency also has a negative effect on the usually unbridled appetite of children. (3)

Right nutrition

Iron deficiency in children causes them to lose their appetite and care must be taken to ensure that they are still eating enough. (Image source: Tanaphong Toochinda / unsplash)

Other consequences of this deficiency can also affect the eating behavior of children. It can even happen that children with iron deficiency develop anorexia over time. Another disordered form of eating behavior is PICA syndrome, in which sufferers eat things that are generally considered inedible. (3)

There is ample evidence that iron is an important component of cognitive, sensorimotor, and socio-emotional development and function, since the development of central nervous system processes is highly dependent on iron-containing enzymes and proteins. Iron deficiency early in life can increase the risk of behavioral disorders. (10)

When does it make sense to influence the child's iron level externally?

Long-term iron deficiency in infants and children can later lead to devastating long-term damage.

As soon as signs of iron deficiency appear in children, it is important to act.

It can even go so far that if iron deficiency is detected too late in children, it can later lead to permanent brain damage. (3)

If children experience a vegetarian or even vegan diet through their parents, it makes sense to have the children's iron levels checked and then proceed accordingly. Iron is mainly ingested through the consumption of meat and generally only through food, which is why alternatives should be sought for this. (1)

From the age of 6 months, infants should be provided with dietary supplements fortified with iron. In any case, it is important to ensure sufficient iron intake from meat and/or iron-containing foods from this period onwards in order to prevent later deficiency symptoms. (6)

What foods contain iron?

Iron is mainly absorbed through the food that you eat. The main supplier of this trace element is meat. However, with the latest trends in nutrition, many people are no longer eating meat because they are following a vegetarian or vegan diet. Therefore, the advantages and disadvantages of meat as an iron supplier are listed below:

  • animal iron can be better absorbed
  • Absorption is hardly influenced by other foods
  • better utilization in the body
  • readily available
  • different preparations available
  • ethical aspect
  • Side effects of meat consumption
  • environmental factors

The type of iron that is absorbed by the body also differs between animal and vegetable iron. In the animal is the so-called heme iron, which can be directly absorbed by the intestine. The non-heme iron is found in plant sources and must first be converted.

Almost every food contains at least a small amount of iron. Legumes such as kidney beans, lentils and chickpeas are at the forefront of plant-based sources of iron. Nuts and foods such as amaranth, wholemeal flour and quinoa are also comparatively rich in iron. (9)

What are the roles of iron in the body?

Iron is an essential trace element for the body with indispensable functions that are explained in more detail in the following section:

  • Reduced physical ability to work, delayed psychomotor development, impairment of cognitive functions in infancy and problems during pregnancy describe the most important features of iron deficiency.
  • Getting enough iron from an early age is extremely important. This can significantly reduce the later risk of stillbirths, premature births or a birth weight that is too low.
  • One of the tasks of iron is also the immune system. It is therefore important to provide children with the necessary amount of iron as soon as possible in order to strengthen their immune system as best as possible and to support the defense against bacteria. (8th)

Iron is responsible for intellectual and psychomotor development, especially in children at an early age. If iron deficiency becomes noticeable too soon, this can have negative effects on the various stages of development. (8th)

What options are there to compensate for iron deficiency in children?

To meet the iron needs of a child there are 2 main variations that can be used. Consequently, the possible variants are described in more detail:

Should I change my child's diet?

Since iron is mainly absorbed through food and diet has been identified as one of the main causes of iron deficiency in children, this is a possible approach. The following are the advantages and disadvantages of changing your diet:

  • long-term benefit
  • natural iron suppliers
  • slow adjustment
  • possible cost factor
  • Envy of other children's food
  • mostly involving the whole family

Basically, it depends on what type of diet you normally follow and to what extent it already contains iron-rich foods. In view of this, the food intake should then be adjusted. (9)

Should I give my child iron deficiency supplements?

If it proves difficult to compensate for the child's iron deficiency through diet, there is also the option of compensating for it with supplements. However, since swallowing pills and drinking unpleasant-tasting juices is no fun even for adults, this is certainly not a celebration for children.

In principle, a discussion with a doctor should take place in advance and/or a blood count should be taken if there is a suspicion of iron deficiency. Iron deficiency has different characteristics, which is why a possible therapy must be individually adapted to the child. (3)

There are already studies on the effectiveness of iron supplementation in children, but not enough to be able to present meaningful results. It is clear that there are small improvements at the cognitive level with iron supplementation in children. A positive influence on growth has not yet been ascertained. (11)


Iron is a necessary trace element for the body, both for adults and children. If an iron deficiency is found in children, which is not uncommon, it should not be underestimated. But there is just as little need to panic, because there are plenty of ways to compensate for this deficit in your child and to optimize the iron level.

In general, it is advisable to tackle the iron deficiency as well as possible through food intake and a possible change in diet. Although supplements also offer a solution, they should really only be used if they have been recommended by a doctor or the like. What should not be forgotten is that there is also the opposite of a deficiency, namely an overdose of iron, which can also have far-reaching consequences. The best thing to do is have your child's blood values ​​checked and, to be on the safe side, include iron-rich food in your diet.


  1. Eber, SW: Most common forms and causes of anemia. Iron deficiency, hemoglobinopathies/thalassemia and hereditary spherocytosis. Monthly Pediatrics1, 2015. Source
  2. Hastka J., Metzgeroth G., Gattermann N.: Iron deficiency and iron deficiency anemia. 2018. Source
  3. Brunner-Agten S., Kaeslin Meyer M., Huber AR: Iron deficiency, brain development and cognitive performance. Swiss Journal of Nutritional Medicine 3/12, 28. 2012 Source
  4. DA-CH reference values ​​for nutrient intake, 2nd edition, 2015. Source
  5. Chen MH, Su TP, Chen YS, et al. Association between psychiatric disorders and iron deficiency anemia among children and adolescents: a nationwide population-based study. BMC Psychiatry. 2013;13:161. Published 2013 Jun 4. doi:10.1186/1471-244X-13-161 Source
  6. Domellof M, Braegger C, Campoy C, et al. Iron requirements of infants and toddlers. J Pediatr Gastroenterol Nutr. 2014;58(1):119-129. doi:10.1097/MPG.0000000000000206 Source
  7. Hercberg S, Preziosi P, Galan P. Iron deficiency in Europe. Public Health Nutr. 2001;4(2B):537-545. doi:10.1079/phn2001139 source
  8. Schumanna, K.; Ettleb T.; Szegnera, B.; Elsenhansc, B.; Solomons, NW: Risks and benefits of iron supplementation: iron intake recommendations critically considered. In: Perspectives in Medicine (2014) 2, 19-39 Source
  9. BfR (2008): Questions and answers on iron in food. Source
  10. Kazal LA Jr. Prevention of iron deficiency in infants and toddlers. Am Fam Physician. 2002;66(7):1217-1224. Source
  11. Thompson J, Biggs BA, Pasricha SR. Effects of daily iron supplementation in 2- to 5-year-old children: systematic review and meta-analysis. pediatrics. 2013;131(4):739-753. doi:10.1542/ peds.2012-2256Source
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