Last week I found out my second son has very low iron. His doctor has requested he start on a supplement, but we're going to have to build up to a full dose. The first day I dosed him with 3/4 of a dose and he had wicked stomach pain, and the day after that for the whole weekend an upset stomach. I *think* that was due to a bug that was making the rounds, but just in case I decided I should slowly introduce it to his system.
He isn't as bad an eater as he used to be, but he eats little amounts, and gets tired of eating. I won't generally force my kids to finish what's on their plates, because they can tell if they're still hungry or satisfied better than I can. I know I fill up quickly, but get hungry often, and we all know our own cues the best. I remember being forced to finish my plate or even to have seconds, and how it made me feel. I won't do that with the boys.
Still, I haven't been very proactive over the last year at making sure there's enough time between his calcium rich foods and his iron rich foods, and about making sure he's actually eating enough iron. He's very much a dairy kid, but some studies have shown that consuming calcium at the same time as iron means that the iron isn't absorbed as well when it comes to short-term. It's also important to plan out a good source of vitamin C to co-mingle with the iron. It helps assure higher iron absorption.
For the last several months our son has been complaining really non-specifically about how he's feeling. "I just feel really terrible" he'll tell us. He'd complain of feeling dizzy, or headache, pain in his legs, and so on. Our doctor sent us home with a blood test requisition and after some schedule juggling we finally have our answer. In part to being a little eater who is also picky, combined with massive growth spurt over the last year, we have this to reconcile.
Common signs of anemia in children (as well as adults) include paleness, weakness, and fatigue. He has great big circles under his eyes and is often tired. He has been prone to frequent infections over the last year- ear infections, throat infections, an eye infection, and plain ordinary colds. Other signs, such as bleeding and sensitive gums and a loss of appetite has also be present. Our doctor suspects that his leg pain and frequent headaches are related to low iron as well. A couple of websites with more information on symptoms and treatment include the Mayo Clinic as well as Children's National.
Our course of treatment will be slow and steady. It's much easier to maintain good iron levels than play catch-up, so I've adopted these rules for our family as a whole. To be honest, I've always tended toward anemia, and I know how terrible he really must have been feeling. 20 years ago I had mono, and my iron count was at a 6- he's at a 9 right now. I remember the exhaustion, dizziness, and overwhelming need to sleep.
The biggest change is making sure there are 2 hours on either side of the iron-rich food that are dairy free. We are spacing out his snacks and meals as best as we can to give his body as much time to absorb iron as possible.
Breakfast includes dairy- a glass of milk and yogurt if he wants it, among whatever else he'd like to eat. I certainly don't want to add calcium deficiency to his life!
Morning snack during the school week is a cheese string (dairy). When he's home from school, morning snack is another opportunity for an iron boost: some apple slices (Vitamin C in one of the few fruits he eats) and some iron-rich cereal such as corn bran or plain cheerios.
Lunch during the school week is a cold little homemade hamburger with apple slices and water, or if we have leftover meat from the dinner before that can easily be cubed up and sent to school to be eaten cold, he'll have those. Always apple slices. We aren't joining the milk program at lunch this year so I can keep dairy away from his lunch break.
After school snack is a peanut butter sandwich with apple juice- there is some iron in peanut butter and bread, though not a large amount.
Dinner is usually another iron-full meal. I try to combine heme with non-heme sources with our dinner as well as other sources of vitamin C besides apples- vegetables, usually, though I often add a couple of different fruits to his dinner plate as well- a strawberry, a few blueberries- to try to get his tastebuds into new flavours.
Bedtime snack incorporates dairy as well, if he wants it, usually a glass of milk or some yogurt.
The biggest challenges for me are remembering what time it is we last ate dairy, and getting dinner ready to eat early enough so he doesn't stay up too late to have a snack. A bedtime snack is a requirement for him because he struggles with an over-production of acid. He's really stepped up to the plate, so to speak, and is trying hard to take his medicine and eat enough of his dinner. He's at the right age to understand cause and effect, so he definitely knows how bad he'll keep feeling if we don't get his iron level higher. We're going to get another blood test early in the new year to confirm that we're going in the right direction.
Iron is tricky, because too much too soon is a problem as well. I'm going with the tortoise and the hare: slow and steady wins the race.
It's also made trickier, because he's somewhat picky. Here are some of the common and best sources of iron. The ones he'll eat are bolded, so you know what I'm working with. Here's a couple of websites so you can do your own research: WebMD and Huffington Post.
And that's my story today, friends. Has anemia had an effect on your life or on the way you eat? Let me know in comments here, start a conversation on my facebook page, or please message me privately! I look forward to hearing from you.