Toddler Multivitamin With Iron, Is It Necessary?

Expert Q&A—Why Children May Need Iron Supplementation

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Q. I have a son that is over a year old. Our pediatrician gave him iron drops because he's no longer taking formula but my son had a reaction to the iron drops and they didn't prescribe him anything else for his iron. I do know that newborns and toddlers need sufficient iron intake for brain development, so what now? 

-Matt, PA

A. In general, toddlers don't need to take a multivitamin with iron. Even though they aren't drinking an iron fortified infant formula anymore, they should be able to get enough iron from all of the other things that they are eating — most children need about 8 to 10 mg of iron per day.

How to Ensure Sufficient Iron Intake in Toddlers

Eating iron-rich, healthy foods is the number one way to prevent and treat iron deficiency. Foods that are usually considered to be good sources of iron include:

  • red meats, fish, and poultry
  • iron fortified cereal
  • oatmeal
  • beans (black, kidney, lima, navy, pinto, soy beans)
  • tofu
  • greens (collard, kale, mustard, spinach, kale, turnip green)
  • iron fortified breads
  • egg yolks
  • dried fruits (raisins, prunes, apricots)
  • natural peanut butter

Does your toddler refuse to eat many of these iron rich foods? If not, then he may very well need some extra iron. In this case, while a vitamin can be helpful, you might also consider giving him a toddler formula instead of whole cow's milk. These toddler formulas include:

  • Enfamil Next Step Lipil
  • Similac 2

Iron Deficiency Anemia in Children

When the body does not have enough healthy red blood cells, a condition called anemia develops.

 Iron helps make red blood cells, which bring oxygen to body tissues, so a lack of iron in the body can mean the following symptoms:

  • Irritablity
  • Shortness of breath
  • Unusual food cravings
  • Loss of appetite
  • Fatigue and weakness
  • A sore tongue
  • Headaches or dizziness
  • In more severe cases, brittle nails, blue-tinged or very pale whites of the eyes

    The medical name of this problem is iron deficiency anemia and if your child was tested and already has iron deficiency anemia, then in addition to eating more foods with iron, he will likely need an iron supplement. These iron supplements, like Feosol, Niferex, and Icar, have much more iron than a simple multivitamin.

    Often, toddlers who drink too much cow's milk and don't ingest enough iron-rich healthy foods may become anemic. Other causes may be because the body is not able to absorb iron well (even with an iron-rich diet) or there is slow blood loss over a long period of time, i.e. due to bleeding in the digestive tract. Lead poisoning may also be a culprit in iron deficiency in children. 

    Multivitamins With Iron

    If you did need to give your toddler a multivitamin with iron, good choices at this age might include:

    • Poly-Vi-Sol with Iron drops
    • Tri-Vi-Sol Drops With Iron

    Keep in mind that most chewable vitamins aren't suitable for toddlers under age 2 years of age.

    Be careful not give your child iron supplements or vitamins with iron without first checking with your pediatrician (too much iron can cause poisoning).

    Your child's doctor will have to be the one to prescribe the right kind of supplement for your child, so if the first supplement they suggested was not a good fit, then be sure to let them know and ask for other solutions.

    Sources:

    Brotanek JM, Halterman JS, Auinger P, et al. Iron deficiency, prolonged bottle-feeding, and racial/ethnic disparities in young children. Arch Pediatr Adolesc Med. 2005;159(11):1038-1042.

    Oski FA. Iron deficiency in infancy and childhood. N Engl J Med. 1993;329(3):190-193.

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