From the Guidelines
Iron supplements are generally not recommended for a 7-year-old child without a confirmed diagnosis of iron deficiency or iron deficiency anemia, as the risk of iron deficiency drops after 24 months and dietary iron and iron status are usually adequate in children over 36 months. According to 1, after age 24 months, the growth rate of children slows and the diet becomes more diversified, reducing the risk for iron deficiency. However, certain risks for iron deficiency may still exist, such as limited access to food, a low-iron or specialized diet, and medical conditions that affect iron status.
Key Considerations
- Children at higher risk for iron deficiency include those with poor dietary iron intake, certain medical conditions affecting absorption, vegetarians/vegans, or those with increased iron requirements due to growth 1.
- Common iron supplements for children include ferrous sulfate, ferrous gluconate, or ferrous fumarate, typically dosed at 3-6 mg of elemental iron per kilogram of body weight per day, divided into 1-3 doses.
- Side effects may include constipation, dark stools, stomach upset, and nausea.
- To improve absorption, iron supplements should be given between meals with vitamin C-rich foods or drinks, and away from calcium-rich foods, tea, or coffee 1.
- Iron supplements should be stored safely away from children as overdose can be dangerous.
- A healthcare provider should confirm iron deficiency through blood tests before starting supplements, as excessive iron can be harmful.
From the FDA Drug Label
Each tablet contains 324mg of ferrous sulfate, equivalent to 65mg of elemental iron, providing 362% of the U.S. recommended daily intake (RDI) of iron for adults and children 4 and older. Each tablet contains 324 mg of ferrous sulfate, equivalent to 65 mg of elemental iron, providing 362% of the U.S. recommended daily intake (RDI) of iron for adults and children 4 and older.
Iron supplementation is appropriate in a 7-year-old child, as the child is older than 4 years, which is the age threshold mentioned in the drug labels 2 and 2.
From the Research
Iron Supplementation in Children
- Iron deficiency is a common cause of anemia in children, and oral iron supplementation is often recommended as treatment 3.
- The American Academy of Pediatrics recommends screening all children for anemia before 1 year of age, and the US Preventive Services Task Force notes that there is insufficient evidence to recommend universal screening of asymptomatic children in the first year of life 3.
- For children with iron deficiency anemia, a recommended dosage of 2 to 6 mg/kg per day of ferrous sulfate is considered effective 3.
Considerations for Iron Supplementation
- Iron supplementation should only be considered in cases where iron deficiency has been diagnosed, as preventative iron administration can be harmful 4.
- The diagnosis of iron deficiency should be based on a baseline set of blood tests, including hemoglobin concentration, hematocrit, mean cellular volume, and serum ferritin levels 4.
- For children aged 6-12 years, a ferritin cut-off of 15 µg/l is recommended, while for younger adolescents (12-15 years), a cut-off of 20 µg/l is recommended 4.
Types of Iron Supplements
- Ferrous sulfate is a commonly prescribed oral iron supplement, but other ferrous salts and ferric complexes are also available 5, 6.
- Novel iron formulations, such as ferric maltol, have been developed and may offer improved tolerability and efficacy 5, 7.
- The choice of iron supplement should be based on the individual child's needs and medical history, as well as the potential for gastrointestinal side effects 5, 6.