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Do Kids Need Iron Supplements?

It's tempting to give your broccoli-hating kids an iron supplement. First, try this.

medical tablet pill on hand of a baby

Iron is a vital nutrient for all humans, but it’s especially crucial for kids. Starting when they’re babies and all the way through their teenage years, their fast-growing bodies and brains rely on this mineral for energy, strength, and normal development. That said, iron supplements aren’t something every kid should take. Getting the right amount of iron, like most vitamins and nutrients, is a bit more complicated than taking a pill.

First of all, iron is essential to the production of hemoglobin, a protein in red blood cells that shuttles oxygen to organs, muscles, tissues, and cells. Without sufficient dietary iron intake, important parts of the body and brain won’t get enough oxygen, meaning they can’t function very well or develop like they should. That’s why children who don’t consume enough iron — or whose bodies don’t adequately absorb the nutrient — may feel sluggish, weak, or foggy-headed. Chronic iron deficiency can even stunt their growth or lead to behavioral, social, or learning problems.

So how much dietary iron is enough to keep kids healthy? Their needs seesaw as they go through different growth stages, so it really depends on their age. For the first six months of life, most newborns get ample iron through breastmilk or fortified formula. Then, from seven to 12 months, as they transition to more solid foods, they require 11 milligrams per day. From age one to three, they need 7 milligrams; from age four to eight, it’s 10 milligrams; and from nine to 13 years old, they’re back down to 8 milligrams.

But then, once kids hit 14 years old, the recommended daily intake jumps again. Boys require 11 milligrams while girls, because they lose iron through menstruation, should get 15 milligrams per day.

Obviously, parents want to make sure their youngsters are getting enough iron. But can kids even get enough of the mineral from food? Or is smart to just give them an iron supplement to make sure the bases are covered?

Iron-Rich Food Sources vs. Supplements

Universally, doctors and dietitians will say it’s always best to get nutrients, including iron, from food rather than supplements. Even though iron supplements are generally safe for kids if used as directed, they’re usually unnecessary. Because in most cases, when toddlers, children, and teens consume well-balanced, nutrient-dense diets, they can absolutely get all the iron they need from their plate. After all, there is smorgasbord of iron-rich foods to choose from, including meat (all types), fish, eggs, peas, chickpeas, lentils, tofu, broccoli, Brussels sprouts, kale, and green beans, as well as iron-fortified cereals, granolas, breads, and pastas.

But of course, in the real world, most kids aren’t begging for Brussels sprouts. And getting them to finish their fish at dinnertime or to stop trading away their turkey sandwich in the lunchroom may be a recurring battle more often lost than won. Also, some children are simply picky eaters who, despite their parents’ best efforts, just won’t eat enough iron-dense foods to meet the daily recommended intake.

And then there are certain life stages at which some kids simply need more iron to stay healthy than the average child their age does. These include kids undergoing a rapid growth spurt, young athletes who train a lot, and teens with heavy periods.

Still, even in these situations, parents should probably hold off on giving them supplements. First, they can try a few strategies to boost their kid’s iron intake, such as trying new iron-heavy recipes for dinner or serving two iron-rich items together for lunch. Also try pairing iron-containing foods (like fortified cereal) with vitamin C-heavy foods (such as berries) because vitamin C helps the body absorb iron.

If those don’t work, or if parents remain concerned about iron deficiency, they should address the issue with their child’s doctor or other health care provider before buying them supplements. The pros know how to evaluate kids for signs of iron deficiency such as muscle weakness, loss of appetite, increased sweating, behavioral issues, or suspiciously slow growth. They may even check the child’s red blood cell count, which, if low, would confirm iron deficiency. At this point, the doctor may indeed recommend kid-friendly iron supplements such as gummies, chews, liquid drops, or powders to mix into their food.

Why Kids Are More Likely to Lack Iron

Besides the picky eaters and “I hate broccoli!” sorts, some kids have specific dietary restrictions that can increase their risk of iron deficiency and potentially necessitate iron supplements. For example, vegetarian kids miss out on all the meat sources of iron, perhaps the fish sources too, while vegan kids don’t get iron from meat, fish, or eggs. While it is possible to get sufficient iron from plant-based foods alone, it’s definitely harder.

Similarly, many children have food allergies or intolerances that may wipe certain iron-rich foods or entire food groups off the menu, making it trickier to get them enough iron. Interestingly, kids who drink a lot of cow’s milk may be lacking on iron too. That’s because cow’s milk doesn’t contain the mineral, but it’s filling, which may stop them from eating other iron-rich foods.

But for other kids, no matter what they eat, their bodies have a difficult time absorbing the nutrients from food, including iron. This can be caused by any number of conditions, such as celiac disease, Crohn’s disease, intestinal damage, or chronic infections. Prolonged antibiotic use can hinder iron absorption as well.

For any of these instances, iron supplements could very well be the best way to boost a child’s iron intake or absorption. But again, always consult with a health care professional first before spending money on supplements for your kid.