Low iron stores are one of the most common mineral problems related to iron among children just like among adults. It is estimated that almost 25% of children suffer from insufficient iron stores . Why is iron important?
Children need iron for psychomotor development, cognitive functioning and growth   and it is found that low hemoglobin level due to insufficient iron stores increases the risk of respiratory infections .
Iron stores decrease fast mainly during the second year of life. First child´s iron stores are depleted (low ferritin) and when iron stores are almost depleted, hemoglobin level starts do decrease (low ferritin and hemoglobin)  .
Insufficient iron stores are common among children under 3 years and main causes of it are increased iron need, small amount of iron from food and big consumption of cow milk products, especially consuming cow milk together with food. Nutrition therapist and Estonian Nutrition Therapy Association´s member of board Triin Muiste reminds that milk is food, not a drink. A lot of parents give their children cow milk as a drink together with food – the most important drink is water and parents should start practicing giving water to their children as early as possible. Other reasons for low iron stores are absorption disorders and increased need for iron among children during growth phases.
In 2007 research in Estonia, it was found that 14% of children suffered from insufficient iron stores and 9% from low hemoglobin levels among 9-12 months old. One of the risk factors was low birth weight – less than 3 kg .
DOES YOUR CHILD SUFFER FROM LOW IRON STORES?
There are many different symptoms:
- tiredness, fatique, decrease in physical activity load, shortness of breath
- irritability, attention disorders
- headache, ringing in the ears
- palpitations, onset or progression of heart failure
- paleness, fragilile nails and hair, crevices in the corners of the mouth, painful tongue, loss of appetite, odd apptetite (need to eat chalk, cement, ice) .
In case of babies and toddlers, low iron stores may also cause sleep disorders.
HOW DO WE KNOW IF WE HAVE LOW IRON STORES?
Insufficient iron stores and low hemoglobin are diagnosed by blood sample. In case of low iron stores results are usually the following:
- blood´s ferritin is low (body´s iron stores)
- increased concentration of transferrin soluble receptors
In case of decreased hemoglobin level results are the following:
- low hemoglobin and hematocrit levels
- red blood cells may be normal or a bit lower
- red blood cell indices (MCV, MCH, MCHC) are usually lower
WHAT ARE THE CAUSES OF LOW IRON STORES?
When your child is suffering from low iron stores, it is important to find out the cause. Some causes are the following:
- absorption disorders and then additional tests might be needed 
- low iron stores are often caused by increased iron need and too little iron intake from food because (for babies and toddles, amount of food eaten is often rather small)
WHAT TO DO?
In case of low iron stores and low hemoglobin level, usually prescription drugs or food supplements are needed that are prescribed by your doctor (in case of food supplements, first consult with your doctor). It is also important to find the cause. Hemoglobin normalizes usually within 4‒6 weeks. To fill your child´s body´s iron stores, treatment should be continued for several months up to half a year, because iron stores increase slowly.
All parents want their children the best and if possible, avoid different additives used in normal prescription drugs and food supplements. It is also easier to give your child iron in syrup form, because very small children cannot manage to swallow a pill. Babies´ intestine is still developing and iron supplements often cause several side effects, e.g. constipation, diarrhea, vomiting, stomach pain and a lot of toddlers refuse to take iron due to its characteristic metal taste.
IRON SUPPLEMENTS FOR CHILDREN
- first iron syrup with iron bisglycinate in Estonia and Finland specifically developed for infants and toddlers
- co-operation with Estonian universities, doctors and chemists
- highly bioavailable and well absorbed iron bisglycinate
- it has been found that iron bisglycinate is absorbed two times more effectively compared to iron sulphate, often used in breast milk substitutes  
- it has also been found that compared to iron-polymaltose complex (iron form often used for children), iron bisglycinate fills more effectively body´s iron stores 
- stomach friendly and usually does not cause side effects, children do usually very well during iron treatment
- from 6 months old for the whole family
- 10 ml = 25 mg of iron
- optimized vitamin C content from orange to reduce oxidative stress related to free iron (the more we use vitamin C together with iron, the more we also cause free unbound iron, which is unhealthy for our cells)
- content of iron and vitamin C is always checked after each batch
- Iron 30 mg pill is also suitable from 6 months old when crushed and is often chosen by families, whose children are not so keen on using iron syrup. Pill can be crushed and then mixed e.g. with fruit smoothie.
- iron syrup is not a source for vitamin K (nettle contains natural vitamin K1) – we have tested vitamin K1 content for all our iron supplements and the results can be found from FAQ
 Tartu University Hospital – Iron deficiency anemia
 Aggett PJ, Barclay S, Whitley JE. Iron for the suckling. Iron nutrition in childhood. Acta Paediatr Scand 1989;78:96-102. 5.
 Male C, Persson LA, Freeman V, Guerra A, van’t Hof MA, Haschke F. Prevalence of iron deficiency in 12-mo-old infants from 11 European areas and influence of dietary factors on iron status (Euro-Growth Study). Acta Paediatr 2001;90:492- 8
 Vendt N, et al. Prevalence and causes of iron deficiency anaemia in infants aged 9 to 12 months in Estonia. Medicina (Kaunas) 2007;43:947–52
 Ekiz C, Agaoglu L, Karakas Z, Gurel N, Yalcin I. The effect of iron deficiency anaemia on the function of the immune system. Forum Nutr 2003;56:243-5.
 Wick M, Pinggera W, Lehmann P. Clinical aspects and laboratory iron metabolism, anemias: novel concepts in the anemias of malignancies and renal and rheumatoid diseases. 5th ed.
 Wien: Springer-Verlag; 2003. p. 7-16. 7. Lozoff B, Jimene E, Wolf A. Long-term developmental outcome of infants with iron deficiency. N Engl J Med 1991; 325:687-94
 Milman N, et al. Ferrous bisglycinate 25 mg iron is as effective as ferrous sulfate 50 mg iron in the prophylaxis of iron deficiency and anemia during pregnancy in a randomized trial. J Perinat Med. 2014 Mar;42(2):197-206. doi: 10.1515/jpm-2013-0153.
 Rossana B. et al. Efficacy of Supplementation with Iron Sulfate Compared to Iron Bisglycinate Chelate in Preterm Infants. Current Pediatric Reviews, 2018, 14, 00-00.
 J.Name et al. Iron Bisglycinate Chelate and Polymaltose Iron for the Treatment of Iron Deficiency Anemia: A Pilot Randomized Trial. Curr Pediatr Rev. 2018 Nov; 14(4): 261–268.