The following appeared in the House Calls column of the Hamilton Spectator on June 4, 2010.
Q: How important is iron in a young child's diet, and what happens if they don't get enough?
A: Iron is an essential mineral, especially for infants and children in particular, because of their rapid growth and increase in muscle mass.
A lack of iron in the diet, or its loss from the body, causes iron-deficiency anemia.
In iron-deficiency anemia, the bone marrow does not have enough iron to produce red blood cells, so it pumps out cells that are too small and too few in number to meet the body's needs.
Most cases of iron-deficiency anemia are mild and go unnoticed, but when severe it can cause paleness, irritability, fatigue, poor feeding and an elevated heart rate.
It can stunt growth, and in older children can even contribute to mental impairment and attention deficit disorder.
So how can you ensure that your child is getting enough iron?
Most healthy-term babies are already fully loaded with iron when they are born. For the first four to six months of life, breastfeeding or using an iron-fortified formula will keep them that way.
Premature infants are another story and may require iron supplements over and above their regular feeds starting as early as one month.
When solid foods are introduced, iron-fortified cereals are a good start. When your child is ready, pureed meats are another good source. Vitamin C helps with the absorption of iron, so serve fruits and dark green vegetables as well.
One of the biggest pitfalls is the early introduction of cow's milk. Store-bought milk is a poor source of iron and, in infants, it can actually cause blood loss through the digestive system. So wait until after your child's first birthday to start.
Also for children aged one to five, limit milk to 20 ounces per day.
While milk is nutritious, it is also high in calories, and if a child's calorie needs are being met by milk alone there will be no room for foods containing iron. The same applies to fatty or sugary snacks and sweetened drinks.
Instead, try red meats, turkey, beans, lentils, baked potatoes (with the skins), enriched cereals and pastas, in moderation, all of which are good sources of iron.
Remember to add vitamin C to their diet.
A balanced diet in an otherwise healthy child should be enough to prevent iron deficiency anemia. If your physician is concerned based on your child's symptoms or diet history, a simple blood test can rule out or diagnose the problem.
Dr. Jonathan DellaVedova is a pediatric resident at McMaster Children's Hospital.
Cow's milk isn't a good iron source, so wait till baby's a year old to start.