Low Iron and Anaemia in Children

A guide for families of children who have recently arrived in Australia

What is anaemia?

Anaemia means the blood does not have enough healthy red blood cells to carry oxygen around the body. It can make a child feel tired, irritable, or short of breath. Low iron is the most common cause of anaemia in children, although there are other causes too.

Anaemia and low iron are common in children from refugee and migrant backgrounds. This is well recognised, and usually easy to treat.

What causes low iron?

Iron is important for growth, energy, and learning. Several things can lead to a child having low iron, including:

• Drinking a lot of cow's milk instead of eating solid foods
• Not enough iron rich foods in the diet, such as meat, shellfish, lentils or spinach
• Breastfeeding for a long time without enough other iron rich foods
• Some infections, including Helicobacter pylori (a stomach infection) or parasites
• Losing blood, for example through heavy periods in teenage girls

Could something else be causing my child's anaemia?

Sometimes anaemia has a different cause. Your doctor may talk with you about:

• Thalassaemia trait: many children of African, Asian, and Middle Eastern background carry this gene, which can cause mild anaemia. This is not the same as thalassaemia disease, and it usually does not need treatment, though it is useful for your family to know about for the future.
• Vitamin B12 or folate: these come from animal foods (B12) and fresh green vegetables (folate). If your family has had limited access to these foods, your child may be tested and may need extra vitamins.
• Lead exposure: sometimes past exposure to the metal lead can also affect the blood. Your doctor will let you know if this is relevant for your child.

How will the doctor check my child?

The doctor will usually arrange a simple blood test to check for anaemia and low iron. Depending on your family's history and where you have travelled from, a few extra tests may also be suggested. Your doctor or nurse will explain what each test is for and will let you know the results as soon as they are available.

How is low iron treated?

If your child has low iron, treatment usually includes:

• Iron liquid or tablets, taken daily for around 3 months
• Giving iron medicine with orange juice where possible, since this helps the body absorb it, and avoiding giving it with milk
• Diet changes, such as more meat, grains, and green vegetables, and less cow's milk if your child is drinking a lot of milk
• Dark stools (poo) or an upset stomach are common side effects of iron treatment and are not harmful, but let your doctor know if you are worried

Will my child get better?

Yes. Low iron and anaemia usually improve well once treatment starts and your child has good access to nutritious food. Your doctor may repeat the blood test after a few months of treatment to check that it has worked.

Questions to ask your doctor or nurse

• What is causing my child's anaemia?
• Does my child need iron treatment, and for how long?
• What foods can help increase iron in my child's diet?
• Will we need a follow-up blood test, and when?
• Is there anything else I should watch out for?