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blood workThere is a strong correlation of developmental delays and behavioral isms with iron deficient anemia.  There are multiple studies that discuss the impacts of iron deficiency, specifically its impact on behavior and development.  Visit Google Scholar and search for iron deficient anemia and behavior and you will discover a plethora of studies examining the impacts of iron deficiency anemia on behavior and development.

Iron deficient anemia in infancy may have long term developmental impacts.  Some studies demonstrated school age children with attentional and behavioral challenges who received iron supplementation demonstrated a causal association between iron status and school performance.(1)

Even with so much documentation, many infants and children do not get routinely screened for anemia.  This is cause for concern as many children are diagnosed with ADHD, Autism and others based on a set of behavioral checklists without first ruling out medical causes.

Parents may wish to consider having their child’s blood tested for anemia.  A simple Complete Blood Count (CBC) is a great place to start as it will demonstrate a clear picture of your blood components and indicate if anemia is present.  Ask your doctor to also assess iron status to avoid having to go back again for a blood test should anemia be discovered through the lab work.  Children ages 0 – 5 who receive WIC Supplementation are often screened for anemia with a simple finger prick blood test.

Causes of Iron Deficiency in Children
There are multiple causes of an iron deficient anemia, but for young children it is most likely related to not getting enough iron in food. Children need a lot of iron and very often are picky eaters.  Another likely cause for young children is that the body may not be absorbing iron well, common in celiac disease.

Symptoms
Anemia develops slowly and symptoms may be so mild, the possibility of anemia often goes unnoticed. As the anemia worsens, children may begin to experience the following:

– Feel weak and tire out more easily – may see a child putting their head on the desk more often or not having energy to partake in recess or gym
– Have trouble concentrating – looking like inattention or distractibility
– Feel dizzy – may not understand what he is experiencing or be able to communicate this sensation, thus appearing distractible or inattentive
– Be grumpy or cranky – irritability may appear as a variety of behavioral isms
– Complain of headaches – may not be able to communicate the experience but may become light sensitive or squint their eyes
– Look very pale
– Feel short of breath with minimal exertion

Babies and small children who have anemia may:

– Be fussy or irritable – may look like many isms
– Have a short attention span – may look like ADD or ADHD
– Grow more slowly than normal.
– Develop skills, such as walking and talking, later than normal.

Adequately assessing a child for anemia as part of the diagnostic process is very important to rule out medical possibilities for concerning behavior.  Anemia in children must be treated to ensure that emotional, cognitive and behavior problems do not linger.

Top Iron Rich Foods
Do not supplement on your own.  Iron is very touchy to supplement as an overdose can be fatal.  The best way to increase iron levels is through dietary adjustments.

The top foods that are rich in iron are featured below including the amount of iron that can be obtained. Although many of these foods may not be a kids top choice, you can sneak them into their diet.

Oysters: Three ounces of wild oysters contain 10.2 mg of iron and boast a healthy helping of Vitamin B12. It is best to purchase farmed Pacific or European oysters to avoid contaminants.   Fried oysters can look like chicken nuggets, just call them oyster nuggets.  Also, consider pureeing cooked oysters and mixing them into spaghetti sauce or macaroni and cheese.  Explore Oyster Recipes

Molasses: One tablespoon boasts 3.5 mg of iron and a nice amount of calcium. Add a touch of molasses to just about anything you prepare for this extra iron boost. Add molasses to gingerbread cookies or quick bread recipes.  Mix a tablespoon of molasses into hot cereal like oatmeal or cream of wheat for breakfast.  Try this fun recipe for a Gingerbread Molasses Smoothie.

White Beans: 3.9 mg of iron per half cup serving is also rich in potassium. A great staple for soups, rice dishes and works well with pasta side dishes.  A food processor comes in handy with beans. Puree the white beans and sneak into unsuspecting foods. Consider mixing up a white bean puree with mayonnaise to spread on sandwiches. Add the puree to macaroni and cheese.  Mix them into muffin mix or cupcake mix.  Check out White Bean Recipes

Cold Cereal: Get from 1.8 to 21.1 mg of iron in fortified cereals. Read the labels to find those with the most iron. Get creative with cereals and use ground up cereals as a breading for chicken or pork dishes. Make home made chicken nuggets or pork strips breaded with crushed corn flakes. Or for an extra boost, bread your oysters above with ground up fortified cereal.

Clams: Offering you the highest bang for your buck, these little guys pack 23.8 mg of iron per 3 ounces. Clams offer a healthy helping of potassium and Vitamin B12! Spaghetti with clam sauce is often a favorite for kids.  Steamed clams are a fun finger food for kids who can then dip the clams in melted butter or cocktail sauce.  Add a white bean puree to the cocktail sauce for an added punch.  Also, clam fritters is another fun finger food!

Soy Beans: Get 4.4 mg of iron in a half a cup! Tofu is a wonderful food staple to sneak iron into your diet because tofu takes on the taste of whatever it is cooked with.  Edamame is a fun finger food for kids.  Steam with a little bit of sea salt and kids have a blast pushing the little beans out of their pods with their tongues.  Great oral motor input too! Make your own hummus for dipping vegetables or spreading on crackers.  Delve into soy bean recipes

Pumpkin Seeds: Perfect time of year in the fall.  When you carve those pumpkins, save the seeds.  One ounce of roasted pumpkin seeds offer 4.2 mg of iron. Have fine motor and sensory fun carving the pumpkin then add to the experience by roasting and toasting the seeds.  Send them off as snacks for school.  In the off season, consider purchasing shelled pumpkin seeds in bulk and add to home made trail mixes or include them in muffin mix.

Organ Meats: Liver and giblets provide 5.2 and 9.9 mg of iron.  I can see it now, you are shaking your head and saying “YUCK”.  Not so fast!  Get creative.  In a recent chat with the local butcher, he suggested beef hearts ground up and added to ground beef. You will never know it is there by taste and it is packed with iron. He stated that in years past, he would have to add beef hearts to ground beef for schools to beef up the iron intake.  Pun intended.  Cook the organ meat, puree it and add to meatballs, meatloaf, meat sauce or tacos! Consider organ meat recipes.

Lentils: Only a half cup will get you 3.3 mg of iron.  Cook and puree. Add a spoonful to brownies, muffins, and other goodies…no one will ever notice!  Lentil soup is delish and perfect on a cold winter night! Sift through some yummy lentil recipes.

Whether your child is dealing with a mild deficiency in iron or is diagnosed with anemia, adding foods rich in iron to their dietary intake will help with behavioral isms and at a minimum, may reduce challenges at home and school.

References
Nokes, Catherine, et. al. “The Effects of Iron Deficiency and Anemia on Mental and Motor Performance, Educational Achievement, and Behavior in Children.” Iron Deficiency Project Advisory Service. A Report of the International Nutritional Anemia Consultative Group, Apr. 1998. Web. 8 Jan. 2014.

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Using her background in health care administration, education and marketing, Tiffani created Special-Ism, an educational resource for parents, teachers, and clinicians of children with various isms. Currently, Tiffani serves as the Editorial Director at Special-Ism, focusing on solutions to the isms for all children at home, in the classroom and community.