WHO recommendation: Iron supplementation for children under 6 years old

The article was professionally consulted with - Specialist I, Resident Doctor Dang Thi Ngoan - Pediatrician - Neonatologist - Department of Pediatrics - Neonatology - Vinmec Ha Long International General Hospital.

Iron deficiency is a common cause of anemia, most commonly in preschool-aged children (under 6 years of age). Iron supplementation for children 5 years of age and younger is associated with hematological, growth and cognitive parameters.

Iron is an essential nutrient for the growth and development of cells in the immune system, blood cells and nerves. Iron also helps regulate energy metabolism during physical activities, participates in the transport of oxygen from the lungs to the rest of the body, so that muscles can store and use oxygen. .
If the diet does not contain enough iron, people can experience a condition called iron deficiency. Iron deficiency in children is a common problem that can affect general growth and lead to anemia if left untreated. This condition occurs on many levels, from mild deficiency to iron deficiency anemia - where the blood will not have enough healthy red blood cells. In fact, the most common cause of anemia is thought to be iron deficiency.

Some babies don't get enough iron for a variety of reasons, which can be traced back to:
Not eating enough; Poor absorption of iron in the diet; Increased need for iron supplements during growth spurts; Blood loss due to helminth infection.

According to statistics of the World Health Organization (WHO), as of 2011 there were about 300 million children globally with anemia. Children are susceptible to iron-deficiency anemia because iron requirements increase during the period of rapid growth, especially during the first 5 years of life. Iron-deficiency anemia in children is associated with increased risk of disease and impaired cognitive development, as well as poor school performance.
Evidence has shown that daily iron supplementation in children aged 24 - 59 months can help increase:
Ferritin: An iron storage protein that indicates whether iron levels in the body are deficient or in excess; Hemoglobin levels: A molecule that controls red blood cells to transport oxygen throughout the body. WHO recommends that public health organizations focus on iron supplementation for children 5 years old and younger (kindergarten age). Especially those who live in places where the rate of anemia in infants and young children is higher than 40%, to increase hemoglobin levels and improve iron deficiency and anemia.

Iron supplements for 3-month-old babies are not usually necessary because babies are born with iron stores already in their bodies. But over time, children need a certain amount of iron to promote rapid growth and development. Iron needs for the body at different ages will change, for example:
Iron supplement for 9 months baby: About 11 mg/day; Iron supplement for children 1 year old - 3 years old: About 7 mg/day; Iron supplement for children 5 years old: Under 10 mg/day; Children from 9 to 13 years old : About 8 mg; Children 14-18 years old: About 15 mg/day (women) or 11 mg/day (men).

If your baby is on iron-fortified formula, it's likely that your baby is getting the recommended amount of iron. In schools who are exclusively breastfeeding, parents can consult their doctor about how and how long to give iron supplements to their babies. On the market today, there are many types of iron supplements in the form of solutions (specific doses) or iron in vitamins.
Some general recommendations for how long to give your baby iron are usually:
Full term Babies Start taking iron supplements at 4 months old, until they eat more than 2 servings per day of various types. iron-rich foods, such as fortified cereals or pureed meats. If you're breastfeeding and your baby is also taking iron-fortified milk as a primary source of nutrition, there's no need to take a supplement.
Premature babies Start adding iron when the baby is 2 weeks old until solid food at 1 year old. If you're still breastfeeding during this time and your baby is also taking iron-fortified milk as the main source of nutrition, there's no need to give your 1-year-old baby an iron supplement.

Other steps you can take to prevent iron deficiency in children include:
Offer iron-rich foods When you start giving your baby solid foods (usually between 4-6 months of age), prioritize Choose foods with added iron first, like whole grains, pureed meats, and mashed beans. For older children, good sources of iron include red meat, chicken, fish, beans, and spinach.
Do not abuse milk Do not give children from 1 to 5 years old more than 710 ml of milk per day to limit the risk of iron deficiency.
Enhance absorption Vitamin C helps promote absorption of iron in the diet. You can improve your child's iron absorption by increasing foods rich in vitamin C. These include: citrus fruits, cantaloupe, strawberries, bell peppers, tomatoes and dark green vegetables.
In short, iron supplementation for children every day helps to increase hemoglobin and ferritin. In addition, the clinical effect of iron supplementation is also related to the improvement of iron deficiency anemia and cognitive development of children.
Iron deficiency in children can be prevented by providing iron-rich foods in meals and snacks. Iron supplements or multivitamins are widely used for children who already have iron deficiency or are just at risk. Parents can also talk to their doctor about the need to screen their baby for iron deficiency anemia and give iron supplements for babies 9 months and older.

Currently, Vinmec is one of the few hospitals with a full range of pediatric specialties, able to perform general examinations in conjunction with a nutritionist to help build a baby menu, neurological examination, mental problems, reflexes. In particular, Vinmec has strengths in physical examination with the cooperation of the rehabilitation center for children with autism - cerebral palsy.
To visit with experienced pediatricians at Vinmec, please book an appointment on the website to be served.

Reference source: who.int; ncbi.nlm.nih.gov; mayoclinic.org

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