Information for Families

Iron is a mineral that is naturally present in many foods, added to some food products, and available as a dietary supplement. Iron is an essential component of hemoglobin, protein in red blood cells that transfers oxygen from the lungs to the rest of the body. Iron is also necessary for growth, development, normal cellular function, and synthesis of some hormones and connective tissues.


Why should my child be screened?

  • Iron deficiency (ID) early in life puts kids at risk of poorer hearing development, poorer mental development and poorer heart function
  • Kids with ID/IDA are at higher risk for infection
  • In toddlerhood, kids who had IDA as infants are more likely to have poorer motor and behavioral development
  • Later in life, kids who had IDA as infants are more likely to experience problems such as high blood pressure

What puts my child at risk for ID and IDA?

  • Mothers who are young, have a higher number of pregnancies, develop gestational diabetes mellitus or are obese will have babies at higher risk of developing ID/IDA
  • Babies who drink cow’s milk or breastfeed exclusively for longer than 4 months are at higher risk of having ID/IDA
  • Babies born with a low birthweight, high birthweight or are part of multiple births (i.e., twins, triplets, etc.) are at higher risk of developing ID/IDA
  • Babies born premature are at higher risk of having ID/IDA

What kinds of tests can diagnose ID and IDA?

Complete Blood Count (CBC)

This test measures all the parts of your child’s blood. It allows your provider to detect if your child is iron deficient before your child develops iron deficiency anemia. The test can also be used to detect other reasons that might make your child anemic. It is usually done as a blood draw by trained phlebotomists. Some phlebotomists can get the blood they need using a finger or heel prick, but this doesn’t always work.

Hemoglobin and Hematocrit (Hb/Hct)

This test measures your child’s red blood cells. Red blood cells are only affected by iron deficiency if your child has already developed iron deficiency anemia. Because red blood cells are the last thing to be affected by iron deficiency, all the other systems that iron is needed for are low on iron before this test would show anemia. This test is usually done as a finger or heel prick.


This test measures how much iron your child has stored in his or her body. Ferritin is a molecule used in the human body to manage how much iron is available to the rest of the body. If ferritin is low, this usually means that your child is iron deficient. This test is usually done as a blood draw by trained phlebotomists.

Screening Questions

In the past, iron deficiency screening was done only for children that were “at risk.” Children were identified as “at risk” based on their parents’ responses to certain screening questions. However, the American Academy of Pediatrics decided that these screening questions were not enough to figure out whether a child was iron deficient. If the screening questions are used, a blood test should be performed to confirm whether a child has anemia.

How can I improve my child’s iron status?

  • Talk to your doctor about whether your child could benefit from incorporating multivitamins into his or her daily diet
  • Vitamin C is important for helping your child absorb the iron in their diet. Make sure to include good sources of vitamin C in their diet, including oranges, tomato juice, etc
  • Know when you or your child is at risk! Children and women are at greater risk for iron deficiency than men or older individuals (≥60 years). Two minority groups, non-Hispanic blacks and Mexican Americans, typically are at greater risk for iron deficiency than are non-Hispanic whites.
  • Get your children excited about eating healthy!
    • Advocate for farm-to-table programs at your school
    • Pay attention to what your child is eating at school
    • Increase fruits and vegetables in the diet at home
  • Check out this Daily Food Plan for Preschoolers designed to help you know how much your child should eat to meet his or her needs.
  • For more information on the iron content in specific foods, visit the USDA Nutrient Database Website.
Alternative Iron Sources

The standard treatment choice for ID/IDA is ferrous sulfate. However, some infants do not tolerate these drops due to the metallic taste. Since there can be long-term negative effects of untreated ID/IDA, it is important to consider other options in treating ID/IDA. The following table describes pros and cons to various alternative iron sources that may work in treating your child’s ID/IDA. Consult your pediatrician before starting any of the supplements below. If you wish to see current research on each product, see this page.

Serving Size Amount of iron per serving (according to label) Appropriate age to use this product Pros Cons
Enfamil Poly-Vi-Sol with iron 1 mL 15 mg = 100% DV infants, 150% DV children under 4 years All ages. The gold standard treatment option. Metallic taste.
Nova Ferrum 1 mL 15 mg = 100% DV infants, 150% DV children under 4 years All ages. Common treatment option. Metallic taste.
Chelated Iron 1 tsp = 5 mL 10 mg = 55% DV All ages. Fewer side effects. Less research.
Upspring Baby Iron + Immunity 1 mL 10 mg = 67% DV infants All ages. Less research.
Earth’s Best Cereals 4 tbsp = 60 mL 45% DV 4 months or older. Taste. Lower absorption and ability for body to use the iron.
Zarbee’s Multivitamin 2 mL 10 mg = 67% DV infants, 100% DV children under 4 years All ages. Effective. Possibly lower tolerance.
Floradix: iron + herbs 10 mL 10 mg = 60% DV for older children 1 year or older. No detectable contaminants. Must be combined with fruit juice and AAP Policy Statement says children under 1 year of age should not be given fruit juice.
Floradix: liquid iron and vitamin formula 5 mL 27% DV 1 year or older. Less research.
BellyBar Prenatal Vitamin 2 chewable tablets 27 mg = 150% DV Intended for mothers. Less research.
Gerber Rice Cereal ¼ cup 45% DV 4 months or older. Taste. Less research.
Flintstones Chewable Multivitamin with Iron ½ tablet for children 2 and 3 years old, 1 tablet for 4 years+ 18 mg = 90% DV children 2 and 3 years, 100% DV children 4 years+ 2 years or older. Absorption is questionable.
Vitamin Friends chewable gummy 1 gummy 15 mg = 150% DV for children ages 2-4, 83% DV ages 4+ 2 years or older. Taste. Less research.
Navitco NutriBear Iron Jellies 1 bear 5 mg = 50% DV under 4 years old, 27% DV ages 4+ 2 years or older. Taste. Less research.
Rite Aid Chewable Multivitamin ½ tablet children 2 and 3 years, 1 tablet children 4 years of age and older 18 mg = 90% DV 2-3 years old, 100% DV children 4 years+ 2 years or older. Taste. Less research.
Liver Fractions 2 capsules 1,300 mg = DV not established Unknown. Readily absorbed. Has not been studied in children.
Beet Juice 1 tsp = 5 mL No DVs given Unknown. Taste.
David Winston’s Iron Extract Herbal Tonic 60 drops DV not established Unknown. Amount of iron depends on the preparation. Less research on it.
Gentle Iron 1 capsule 25 mg = 139% DV 2 years or older. Fewer side effects and better compliance than the standard treatment of ferrous sulfate. Not as much research available as the standard (ferrous sulfate).
Gerber Graduates Strawberry Apple Puffs 60 pieces 10% DV infants, 15% DV children 1-4 1 year or older. Taste. Large serving size for only 10-15% DV iron.
NutriPure Chewable Iron with Vitamin C 1 tablet (melts in mouth) 18 mg = 100% DV (adults) 2 years or older. Taste. Less toxic and more slowly absorbed than the standard (ferrous sulfate). Less research.
Lucky Iron Fish N/A N/A 1 year or older. Versatility. Less research on the amount of iron actually absorbed.

What should I know if I’m pregnant?

During pregnancy, you need more folic acid and iron than a woman who is not pregnant.

Iron is important for the body to carry oxygen to your organs and the rest of your body. During pregnancy, women require twice their normal amount of iron in order to supply oxygen to the baby. The daily recommended dose of iron during pregnancy is 27 mg, which is found in most prenatal vitamin supplements. You can help your body absorb all the iron it needs by eating iron-rich foods, including lean red meat, poultry, fish, dried beans and peas, iron-fortified cereals and prune juice. Iron can be absorbed more easily if iron-rich foods are eaten with vitamin C-rich foods, such as citrus fruits and tomatoes.

Try out this Daily Food Plan that helps you track the foods and amounts that are right for you at your stage of pregnancy or when breastfeeding.

What if I’m a vegetarian?

Vegetarian diets can meet all the recommendations for nutrients, including iron. As is true with non-vegetarian diets, the key for ensuring that you have enough iron in your meals is to consume a well-balanced diet.

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