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Column originally published Aug 30, 2016

Iron Deficiency Anemia

Question: Last week, I brought our three-year-old son to his family doctor because he had an ear infection. When our doctor checked him, she found that he was rather pale. I never noticed it, our son has very fair skin. A blood test confirmed that his blood count was very low; he has iron deficiency anemia. Looking back, he has been more irritable and become tired easily in the last few months. He loves milk, he can drink it all day without eating. I never thought it can be a problem. I grew up on a dairy farm, I always thought that drinking milk will make him healthy and strong. His doctor gave him some iron drops. How long should he take this? Is there anything else that I can do?


Iron deficiency anemia is a common problem in children and adults. It happens when we don’t consume enough of iron-containing food, or when we lose blood (usually from the intestines) over a long period of time.

Every cell in our body needs iron. This is especially true for red blood cells (RBC). Iron is the major component of hemoglobin, a reddish protein inside RBC that transport oxygen from our lungs to all parts of the body. If we don’t have iron, we cannot produce hemoglobin and RBC. This results in iron deficiency anemia.

Our muscles also need iron. Growing children like your son need iron to produce new muscle cells and replace injured ones. Iron is also important for brain cells. Research has shown that children who lack iron can have lower IQ and difficulty in learning.

If iron is so important for our body, how come we don’t hear much about it? This is because iron supplements are fairly cheap, pharmaceutical companies cannot sell large quantities like probiotics. Furthermore, if we eat a healthy diet with good variety of nutritious food, there will be enough iron for our body. Extra iron that we consume and absorb will be stored in the bones, to be used when there is a temporary lack of iron consumption.

Milk is a staple food in North America; it is recommended in the Canadian food guide. It has good amount of calcium, protein, and lactose. However, it has very little iron. Many parents think that drinking milk is good, therefore, more milk must be better. Unfortunately, this is completely wrong. Drinking too much milk and not eating enough solid food deprived your son of iron. Over time, the iron that was stored in his bones was used up. He was not able to produce new hemoglobin and RBC, leading to iron deficiency anemia.

Iron supplement should be given two hours after, and one hour before drinking milk. This is because milk can bind up the iron and make it harder to be absorbed into the body. Over a few weeks, his body will produce new red blood cells and he will feel better. You should use it for about six months; this will replenish the iron storage in the bones. Just a little warning here: you will see his stool turning dark, and he may become somewhat constipated. This is because the iron supplement is not completely absorbed.

You should also limit his milk intake to no more than two glasses a day. He should drink the milk after he has finished his meals, otherwise he may not be hungry to eat. Red meat and dark green vegetables are the best source of natural iron, although iron is present in almost all food that we consume, with the exception of milk.