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 Bibhu Ranjan Mund, MPH (Public Health Expert) with experience in maternal, infant, child, and adolescent health programs. Content is based on evidence-informed guidelines aligned with organizations such as the World Health Organization, UNICEF, Centers for Disease Control and Prevention, and National Institutes of Health.
Last reviewed on: 22 March 2026.

Medical Disclaimer: This content is for informational and educational purposes only and is not intended as medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare professional regarding any medical condition or concerns.

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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.

Global Iron Deficiency & Anemia Snapshot

Indicator Global Estimate Source Year
Children under 5 affected by anemia ~40% globally World Health Organization Global Anemia Estimates 2023
Most common nutritional deficiency worldwide Iron deficiency World Health Organization Global Anemia Estimates 2023
Children 6–23 months at highest risk Yes (rapid growth phase) UNICEF Nutrition Report 2022
Anemia contributes to global disability burden (DALYs) Recognized contributor World Health Organization 2022
Iron deficiency anemia in children its causes

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.

Daily Iron Requirements in Early Childhood

Age Group Recommended Iron Intake Source Year
0–6 months 0.27 mg/day (adequate intake) National Institutes of Health Office of Dietary Supplements – Iron Fact Sheet 2023
7–12 months 11 mg/day NIH Office of Dietary Supplements – Iron Fact Sheet 2023
1–3 years 7 mg/day NIH Office of Dietary Supplements – Iron Fact Sheet 2023
Essential iron for infants and toddlers

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.

Potential Developmental Areas Affected by Iron Deficiency

Area Observational Findings in Research Source Year
Motor skills Slower motor development observed World Health Organization 2023
Cognitive function Association with learning challenges National Institutes of Health 2023
Behavior Reduced attention span in some studies NIH 2023
Growth and development of brain

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.

Common Risk Factors for Iron Deficiency (6–24 Months)

Risk Factor Why It Increases Risk Source Year
Rapid growth Increased iron demand World Health Organization 2023
Low birth weight Reduced iron stores WHO 2023
Prematurity Incomplete iron transfer before birth WHO 2023
Excess cow’s milk intake May interfere with iron balance American Academy of Pediatrics 2022
Vulnerability of children between 6m-24m for iron deficiency

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-Rich Foods for Children (6–24 Months)

Food Type Iron Type Relative Absorption Source Year
Meat, chicken, fish Heme iron Higher absorption World Health Organization 2023
Lentils, beans Non-heme iron Moderate (improves with vitamin C) WHO 2023
Iron-fortified cereals Fortified iron Designed for improved intake UNICEF 2022
Spinach, leafy greens Non-heme iron Lower absorption without vitamin C WHO 2023

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.

WHO Guidance on Iron Supplementation (General)

Age Group Preventive Supplementation Context Source Year
6–23 months In settings with high anemia prevalence World Health Organization 2016 (ELENA guideline, still referenced 2023)
Low birth weight infants May require individualized plan WHO 2023
Premature infants Under medical supervision WHO 2023

Supplementation decisions should be made by healthcare providers.

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.

Factors Affecting Iron Absorption

Enhances Absorption May Reduce Absorption Source Year
Vitamin C-rich fruits Excess cow’s milk World Health Organization 2023
Fermented foods Tea (tannins) WHO 2023
Animal-source protein Phytates (some grains) NIH 2023
How to improve the Vitamin-C absorption

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.

Guidance for Cow milk and absorption of iron

Monitoring Iron Status in Young Children

Monitoring Tool Purpose Source Year
Hemoglobin test Detect anemia World Health Organization 2023
Growth monitoring Assess nutritional status UNICEF 2022
Dietary assessment Evaluate iron intake patterns WHO 2023

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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