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Anemia is the condition in which a person has either too few red blood cells (RBC) or too little hemoglobin within their red blood cells. Hemoglobin is the protein responsible for carrying oxygen, thus with too few red blood cells or too little hemoglobin, insufficient oxygen is transported to the body’s tissues and organs. Anemia commonly causes a patient to feel tired, short of breath, develop frequent infections, or experience heart palpitations. On the other hand, patients may be anemic and asymptomatic as well. The most common reason of anemia is iron deficiency. About 2 billion people have anemia in the world due to iron deficiency.
Causes of Anemia
- Decreased red blood cell (RBC) production
- Increased RBC destruction - hemolytic anemia
- Excessive bleeding
Risk of Iron Deficiency Anemia
- Premature babies don’t have enough time to accumulate iron in utero and grow faster than term infants, which may deplete iron stores within 2 to 3 months.
- Infant with low birth weight and infants fed non-iron fortified infant formula.
- Breastfed infants who are receiving inadequate dietary iron after age 6 months.
- Infants with poor weight gain
- The early introduction of whole cow milk before 1 year of age or take > 24 oz of whole cow milk per day after the first year of life. Cow milk is low in iron.
- Drinking too much cow milk may affect iron absorption and cause occult bowel bleeding.
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Associated Problems with Iron Deficiency Anemia |
- Poor growth
- Mental and motor developmental delays
- Cognitive impairment,
- Behavior disturbances
- Increased susceptibility to infection
- Increases lead absorption and increase blood lead level
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Prevention of Iron Deficiency Anemia and Screening |
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| Birth |
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Encourage breastfeeding until 12 months of age.
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Give only iron-fortified formula (10 to 12 mg/L) for infants who are not breastfed.
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For breastfed infants who were preterm or of low birthweight, give 2 to 4 mg/kg per day of iron drops (maximum of 15 mg/d) and screen for anemia before 6 months old.
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| 4-6 months old |
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| 6 months old |
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| 9-12 months old |
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Initial routine anemia screening test for infants between ages 9 and 12 months of age and again 6 months later, esp. for infants at risks of iron deficiency anemia
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Introduce plain pureed meats.
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Don’t introduce cow milk before 12 months of age.
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1-5 years old |
- Encourage iron-rich foods, limit milk consumption to 24 oz daily.
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| 6 years old and above |
- Encourage iron-rich foods and foods rich in vitamin C to improve iron absorption
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Recommended Daily Allowance of Iron
Age Group |
Recommended Daily Allowance (RDA) |
Pregnancy/Lactation |
Males |
Females |
0-6 mo* |
0.27 mg |
0.27 mg |
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7-12 mo* |
11 mg |
11 mg |
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1-3 y |
7 mg |
7 mg |
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4-8 y |
10 mg |
10 mg |
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9-13 y |
8 mg |
8 mg |
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14-18 y** |
11 mg |
15 mg |
27 mg/ 10 mg |
19-50 y** |
8 mg |
18 mg |
27 mg/ 9 mg |
51+ y |
8 mg |
8 mg |
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Source: NIH Office of Dietary Supplements
*For infants under the age of 12 months, the value given as the RDA is actually the ‘Adequate Intake’ The value is based on the iron content of human breast milk.
**Note the increased iron requirements for menstruating, pregnant, and lactating females.
Iron-Rich Foods
Sources of iron include red meats and dark, leafy greens. See the table below for specific examples of both iron-rich and iron-poor foods.
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Foods |
Milligrams (mg) per serving |
Meat
Proteins |
Sardines, Atlantic, canned in oil, drained solids with bone, 3 ounces |
2 |
Beef, braised bottom round, trimmed to 1/8" fat, 3 ounces |
2 |
Chicken, roasted, meat and skin, 3 ounces |
1 |
Beef liver, pan fried, 3 ounces |
5 |
Tuna, bluefin, fresh, cooked with dry heat, 3 ounces |
1 |
Turkey, roasted, breast meat and skin, 3 ounces |
1 |
Oysters, eastern, cooked with moist heat, 3 ounces |
8 |
Egg, hard boiled, 1 large |
1 |
White beans, canned, 1 cup |
8 |
Kidney beans, canned, ½ cup |
2 |
Lentils, boiled and drained, ½ cup |
3 |
Chickpeas, boiled and drained, ½ cup |
2 |
Cashew nuts, oil roasted, 1 ounce (18 nuts) |
2 |
Nuts, pistachio, dry roasted, 1 ounce (49 nuts) |
1 |
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Grains
Starches |
Rice, brown, long or medium grain, cooked, 1 cup |
1 |
Breakfast cereals, fortified with 100% of the DV for iron, 1 serving |
18 |
Rice, white, long grain, enriched, parboiled, drained, ½ cup |
1 |
Spaghetti, whole wheat, cooked, 1 cup |
1 |
Bread, whole wheat, 1 slice |
1 |
Bread, white, 1 slice |
1 |
Potato, baked, flesh and skin, 1 medium potato |
2 |
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Fruits
Vegetables |
Spinach, boiled and drained, ½ cup |
3 |
Tofu, firm, ½ cup |
3 |
Tomatoes, canned, stewed, ½ cup |
2 |
Green peas, boiled, ½ cup |
1 |
Broccoli, boiled and drained, ½ cup |
1 |
Raisins, seedless, ¼ cup |
1 |
Mushrooms, white, sliced and stir-fried, ½ cup |
0 |
Cantaloupe, diced, ½ cup |
0 |
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Dairy, etc. |
Chocolate, dark, 45%–69% cacao solids, 3 ounces |
7 |
Cheese, cheddar, 1.5 ounces |
0 |
Cheese, cottage, 2% milk fat, ½ cup |
0 |
Milk, 1 cup |
0 |
Source: NIH Office of Dietary Supplements |
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Referrence |
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