Milk Free Diet for Iron Deficiency Anemia

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What is Iron Deficiency Anemia?

Iron Deficiency Anemia (IDA) is the most common type of anemia. Iron is found in certain foods and our bodies use the iron to form hemoglobin to bring oxygen to the cells in your body. When iron is low, there can be a number of unwanted changes to the body. Some symptoms of IDA include fatigue (tiredness), pale skin, weakness, poor appetite, headache, irritability, unusual food cravings, and impaired growth and development. In infants and preschoolers, IDA can result in developmental delays and behavioral problems.

What are the common causes of Iron Deficiency Anemia in Children?

• Excessive milk intake
• Poor solid food intake

Why does excessive milk intake cause Iron Deficiency Anemia?

Milk has some good qualities (fat, protein, calcium, vitamin D, etc.). However, milk and milk substitutes (like soy milk) are not good for children with Iron Deficiency Anemia for a number of reasons:

1. Milk and milk substitutes are poor sources of iron.
2. Milk interferes with the body’s ability to absorb iron from food and supplements.
3. Excessive cow’s milk can cause microscopic damage to the intestines and cause small amounts of blood loss. When blood is lost, iron is lost with it.
4. Excessive milk intake can lead children to consume fewer solid foods because they fill up quickly on the liquid. Solid foods are where the iron in a child’s diet typically comes from.

How is Iron Deficiency Anemia treated?

1. No milk or milk substitutes. Remove all milk and milk substitutes from your child’s diet. Encourage your child to drink water and up to 8 ounces of juice per day. Once your child’s hemoglobin and iron levels have been restored, you may add small amounts of milk back into the diet. Your provider will tell you when your child can drink milk again, expect about 2-4 weeks. Once your child is able to have milk again, follow USDA guidelines for recommended amounts. Children ages 2-3 years are limited to 16 ounces per day and children 4-8 years are limited to 20 ounces per day. Milk consumption above this may result in having Iron Deficiency Anemia once again.
2. Encourage good food sources of iron at each meal (see included list ).
3. Match iron sources with Vitamin C sources to increase absorption (see included list ).
4. Give your child their iron supplement as prescribed. Offer the iron supplement with a source of Vitamin C (like a small amount of orange juice) to increase absorption.
5. Give your child 3 meals and 2-3 snacks each day at scheduled times to promote better hunger. Do not allow grazing in between these times as grazing does not promote good hunger. Offer only water to drink in between meals and snacks.
6. Offer only a small amount of liquid with meals at first and help your child eat the solid foods.
7. If your child is over 1 year of age and still using a bottle, stop having your child drink from the bottle as soon as possible. Never ever put child to bed with bottle. Liquids such as milk and juice contain sugars that sit on around a child’s gums and teeth and promote very early tooth decay.

Sources of Iron (meats and animal sources best absorbed)

Baby Foods:

• Meats
• Green peas
• Spinach
• Sweet potatoes
• Rice cereal
• Oatmeal cereal
• Brown rice cereal

Table Foods:

• Beef and pork
• Lamb
• Chicken and turkey
• Duck
• Fish – especially cod and tuna
• Shellfish – shrimp, clams/mussels/oysters
• Sardines and anchovies
• Egg yolks
• Leafy greens – kale, turnip greens, collard greens
• Beans and legumes – lima beans, dry beans, pinto beans, baked beans, lentils
• Peas – green peas, black eyed peas
• Whole wheat bread, pasta, rice
• Ready to eat cereal

Sources of Vitamin C

Vitamin C increases the body’s ability to absorb iron

• Citrus fruits – oranges, grapefruits, 100% orange or grapefruit juice
• Pineapple
• Strawberries
• Raspberries
• Cantaloupe
• Kiwi
• Mango, papaya
• Bell peppers – red, orange, green
• Broccoli, cauliflower
• Tomatoes
• Cabbage
• Potatoes
• Leafy greens
• Brussel sprouts

Iron Supplements – Tips for Taking

Give iron supplements as prescribed by the doctor.

For liquids:

• Try mixing in a couple ounces of orange juice, grape juice, or cranberry juice (or other citrus or tart juice) or pureed fruit.
• If administering in a syringe – try dipping the dip in a little bit of chocolate syrup.

For chewable/tablets:

• If your child has older siblings who take medications or vitamins, have them all take at the same time. Sometimes seeing an older sibling take theirs will help encourage them.

Questions?

This information is not specific to your child, but provides general information. If you have any questions, call your clinic.

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