Iron Deficiency Anemia in Children (6–24 Months): Causes, Prevention & Iron Supplementation
Discover how to prevent iron deficiency anemia in children aged 6–24 months, including symptoms, iron-rich foods and WHO-recommended guidance.
Reviewed by Public Health Expert (MPH), with experience in maternal and child health programs.
Medical Disclaimer : This information is for educational purposes only and does not replace professional medical advice. For personalized guidance, consult a qualified healthcare provider. This article was reviewed by a Public Health Expert (MPH) with experience in maternal, infant and child health programs aligned with WHO and UNICEF frameworks.
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Iron supplementation is not required for all children and should be considered only when recommended by a healthcare provider.
Iron Deficiency Anemia :
Iron deficiency anemia (IDA) is a nutritional problem, which arises due to the lack of sufficient iron to make the required hemoglobin. Hemoglobin is responsible for transporting oxygen in the blood. Low hemoglobin levels may affect a child’s energy levels, growth, and brain development.
Iron deficiency anemia is considered one of the most significant nutritional risk factors to disability adjusted life years (DALYs) especially among infants and young children is iron deficiency anemia around the globe. Especially vulnerable are the infants (0- 12 months) and toddlers (1- 5 years old) since they are rapidly growing and have higher nutritional demands.

Why Iron is Essential in Infants and Toddlers?
Iron plays a key role in:
- Brain development
- Development of red blood cells that are healthy.
- Cognitive development, motor development.
- Immune system function
At an early age of childhood, particularly between 6 and 24 months, the body and brain develop at their highest rate. This is a critical stage where iron requirements are inadequately addressed in case developmental delays are encountered.

Growth and Brain Development of Iron-Deficiency
Iron deficient anemia may cause various developmental and behavioral problems in children and such may include:
- Impaired motor development and retarded development.
- Limited social interaction
- Unhealthy cognitive and brain development.
- Loss in attention and concentration.
It has been indicated that some of the developmental delays linked to early iron deficiency could continue to school-going age unless early intervention is administered.

Why Highest Vulnerability of Children Between 6 and 24 Months Old?
Between 6-24 months, there is a high risk of iron deficiency due to the following reasons:
- The iron stores of birth start to deplete at about the age of 6 months.
- Increasing iron needs cannot be satisfied with breast milk beyond this age.
- Quick body and brain development enhances the iron requirement.
Babies born with low birth weight (below 2,500 grams) or too prematurely may need to be monitored and treated earlier than recommended by a health care specialist.

Iron Deficiency Anemia in Children Prevention.
Exclusive Breastfeeding (06 Months)
The first six months of life should be fed on only breast milk. Although breast milk is rich in iron that is very easily absorbed, the amount is insufficient to sustain a baby after the age of six months.
Addition of Iron-Enriched Complementary Foods (6 Months after)
Complementary foods that contain iron should be introduced at the six months with the constant breastfeeding continued. Suitable options include:
- Iron-fortified cereals
- Pureed meat, chicken or fish
- Lentils, beans and pulses
- Spinach and green leafy vegetable cooked.
- Egg yolk (one of the recommendations of a pediatrician)

Iron Supplementation -When Advocated
Diet alone may not be adequate in iron in many children particularly those who are at risk. Under these circumstances, medical workers can suggest iron supplementation, usually iron drops.
- Preventive dosage is usually based on a medical professional.
- Earlier supplementation could begin in underdeveloped infants of low weights or premature birth.
- Only under the medical supervision should iron supplements be administered.
The low iron stores even in children with normal hemoglobin levels may impact on cognitive development.

Improving Vitamin C Iron Absorption.
Vitamin C increases the absorption of non-heme iron in plant-based food. From six months of age, vitamin C-rich foods can be introduced to support iron absorption.
- Oranges
- Strawberries
- Tomatoes
- Bell peppers
- Vegetables and fruits eaten with the meals.

Important Guidance, Cow Milk and Absorption of Iron
- Cow’s milk should not be given during the first 12 months of life. After one year of age, intake should be limited to no more than 500 ml per day.
- Following one year of age, it should be taken in a minimum of not more than 500 ml daily.
- The presence of excessive cow, goat or soy milk may disrupt the absorption of iron and predispose one to the risks of iron deficiency.

Concluding Points :
Iron deficiency anemia is a widespread but avoidable nutritional disorder at the early childhood period especially between the ages of 6 and 24 months. This is a critical stage in brain development and general development and therefore adequate intake of iron is necessary.
Early education, frequent check-ups and healthy eating habits are central to the protection of the health and developmental capabilities of a child.
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Trusted References and Research Sources:
- WHO Guideline on Iron Supplementation and Child Nutrition
🔗 https://iris.who.int/bitstream/handle/10665/204712/9789241549523_eng.pdf - NCBI – Complementary Feeding and Child Nutrition
🔗 https://www.ncbi.nlm.nih.gov/books/NBK285660/ - WHO Elena Intervention – Iron for Children 6–23 Months
🔗 https://www.who.int/tools/elena/interventions/iron-children-6to23 - NCBI – Anemia in Infants and Young Children
🔗 https://www.ncbi.nlm.nih.gov/books/NBK236493/ - WebMD – What to Know About Anemia in Kids
🔗 https://www.webmd.com/children/anemia-in-kids-what-to-know - Healthline – Childhood Anemia Overview
🔗 https://www.healthline.com/health/anemia/anemia-in-kids - PMC Article on Childhood Anemia and Nutrition
🔗 https://pmc.ncbi.nlm.nih.gov/articles/PMC9029079/
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