How to administer iron supplementation to children to ensure adequate intake?

From the Guidelines

To get kids to take iron supplements, mix liquid iron drops with a small amount of juice or add them to the back of the tongue followed by a favorite drink, as recommended by the Centers for Disease Control and Prevention 1. For breast-fed infants who receive insufficient iron from supplementary foods by age 6 months, suggest 1 mg/kg per day of iron drops, according to the Centers for Disease Control and Prevention 1. Some key points to consider when giving iron supplements to kids include:

• Mixing liquid iron drops with a small amount of juice or adding them to the back of the tongue followed by a favorite drink
• Using chewable iron supplements with appealing flavors for older children
• Crushing tablets and mixing with food like applesauce or yogurt
• Starting with small doses and gradually increasing to reduce side effects like stomach upset or constipation
• Giving iron with vitamin C-rich foods to improve absorption, while avoiding milk or calcium-rich foods within two hours of supplementation to prevent decreased absorption
• Establishing a consistent routine, using positive reinforcement, and being honest but encouraging about the importance of iron for energy and growth
• Consulting a pediatrician about alternative formulations if taste remains an issue It's also important to note that iron supplementation is crucial for preventing anemia, supporting brain development, and maintaining energy levels in growing children, especially for picky eaters, vegetarians, or those with increased iron needs, as highlighted in the recommendations to prevent and control iron deficiency in the United States 1. Additionally, recent guidelines on pediatric parenteral nutrition emphasize the importance of iron supplementation, recommending that iron supplementation should preferentially be given enterally rather than parenterally, if tolerated, and that routine provision of iron in parenteral nutrition should not be given for short-term PN (<3 weeks) 1.

From the FDA Drug Label

DIRECTIONS FOR USE: Do not crush or chew tablets. Adult Serving Size: 1 tablet two to three times daily. Children: Consult a physician.

The FDA drug label does not answer the question.

From the Research

Iron Supplementation for Kids

To get kids to drink iron supplements, it's essential to consider the form and taste of the supplement.

• Iron supplements come in various forms, including ferrous sulfate, iron bis-glycinate chelate, and ferrous ammonium phosphate, as seen in studies 2, 3, 4.
• The bioavailability of iron in these supplements can vary, with ferrous sulfate and ferrous ammonium phosphate showing higher bioavailability than ferric pyrophosphate 4, 5.
• Some studies suggest that lactoferrin, a milk-derived iron-binding glycoprotein, may be a better option for kids due to its improved gastrointestinal tolerance and fewer side effects compared to ferrous sulfate 6.

Tips for Administration

• Mixing the iron supplement with a small amount of food or drink, such as milk or juice, may make it more palatable for kids.
• Choosing a supplement with a pleasant taste or odor can also increase compliance.
• It's crucial to follow the recommended dosage and administration instructions to ensure the supplement is effective and safe.

Monitoring and Follow-up

• Regular monitoring of iron levels and hemoglobin concentration is necessary to assess the effectiveness of the supplement.
• Adjusting the dosage or switching to a different supplement may be necessary based on the child's response to treatment, as seen in studies 2, 3, 4.