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Iron Deficiency in Babies & Toddlers

Iron Deficiency in Babies & Toddlers

Is Your Child a ‘Milk Baby’?

Is your child a ‘milk baby’?

“I don’t know…IS my child a ‘milk baby’?

“What is a ‘milk baby’?

“Do I need to be concerned’?

The term ‘milk baby’ refers to babies and toddlers who suffer from iron deficiency anemia (IDA) as a result of drinking too much milk.

HOW MUCH IS TOO MUCH MILK?

A baby or toddler that consumes more than 2-3 cups (16-24oz) of milk daily can be considered excessive.  Generally, it's when they are drinking a litre of milk or more every day…yes, it happens. This can lead a child down a very quick path to IDA.

IRON DEFICIENCY ANEMIA…SO WHAT?

Iron deficiency is the most common nutrient deficiency in children.  The typical cause of iron deficiency in younger children (0-24 months) is the excessive intake of cow’s milk or milk substitutes.  When iron in the body is low, there can be a number of harmful effects. It is a serious problem. 

A child's brain and body NEED a lot of iron. 

Due to the high demand of a child’s body for iron, an iron-deficient child must be treated quickly and appropriately. Iron is crucial for growth and development and there are possible long-term impacts of iron deficiency such as poor growth, decreased intelligence and cognition.

SIGNS & SYMPTOMS OF IRON DEFICIENCY ANEMIA?

Parents see their children every day so they may not notice signs that their child is iron deficient. It is a good idea to have a practitioner examine them at regular intervals. Oftentimes a child will grow well when plotted on a growth chart as they are getting adequate calories and protein from the excessive milk intake they are drinking. BUT they are missing out iron, like we talked about above.

Look for these signs:

  • fatigue

  • pale skin & dark circles under the eyes

  • pale lips & tongue

  • weakness

  • poor appetite & possible poor weight gain

  • headache or dizziness

  • irritability

  • PICA - unusual food cravings (paint, dirt, paper)

  • impaired growth and development

  • in infants and preschoolers, IDA can result in developmental delays and behavioural problems

HOW CAN TOO MUCH MILK CAUSE IDA?

You might be asking “I thought milk was good for babies”.  Milk does have good qualities (protein, calcium, vitamin D, etc.) and children can grow well because of these nutrients. However, cows milk and milk substitutes (like soy, almond, coconut mylks) when introduced too early or when they are a sole source of nutrition, can lead to IDA for a number of reasons.

  • Milk and milk substitutes are very poor sources of iron;

  • Milk interferes with the body’s ability to absorb iron from food and supplements;

  • Cow’s milk can cause intestines to lose small amounts of blood. When blood is lost, iron is lost also;

  • Too much milk = lots of liquid = full tummies = less solid foods. Solid food is where the iron in a child’s diet typically comes from;

  • Breastfeeding for extended periods of time, without the addition of iron-rich foods.

WHAT CAN BE DONE?

Be ready for a battle.  A child who loves milk, especially in a bottle, will be your toughest competition.  They will cry, scream, throw a tantrum, refuse all food and give you the fight of your life.  You need to persevere because you are fighting for THEIR life.  So, try these approaches:

  1. Offer no more than 16-20 ounces of milk per day.

  2. Encourage good food sources of iron at each meal.

  3. Pair iron-rich foods with vitamin C sources to increase iron absorption.

  4. Try serving 3 meals and 2-3 snacks each day at scheduled times to promote better hunger. Try not to allow grazing in between these times.

  5. Offer only a small amount of liquid with meals initially and encourage your child to eat solid foods.

  6. If still bottling and over one year of age, wean the child from the bottle as soon as able.

  7. Wean milk by adding water to it and offering a smaller bottle at each feeding.

  8. If a child has been diagnosed with severe IDA, an iron supplement will be prescribed as food choices will not replenish iron stores alone. Ensure the child takes this supplement as prescribed, make the previous changes and reassess iron status in three months.