Toddlers who eat fruit as a snack rather than with meals are three times more likely to have iron deficiency. “But I thought it was healthy to give my child fruit as a snack,” commented the health professional sitting near me. “It is,” replied Dr Clare Wall, one of three child nutrition experts speaking at a seminar I attended this week. “But it’s also important for toddlers to eat fruit with a meal because it increases iron absorption from that meal.”

One in six Kiwi toddlers are iron deficient and around two-thirds don’t eat enough iron to meet the recommended daily intake. For most, it’s not bad enough to cause anaemia but it is bad enough to affect their behaviour and brain development. And if your five-year-old loves red meat it doesn’t make up for what they missed out on three years earlier.

Iron is concentrated in the basal ganglia part of the brain and in the myelin sheaths which act as a conductor for the nerves, speeding up reaction times. A shortage of iron as these critical parts of the brain are forming (80% of the adult brain is developed by age 3) means the child gets short-changed on their full brain potential. Children who are iron deficient have a slower transmission time through their auditory and visual pathways. Show them a toy and they are slower to grab it, teach them a skill and they are slower to get it. They are often less interactive and less easily soothed but most importantly they don’t learn so well – and this lasts into school age.

In a typical family it’s the mum and the toddler who need the most iron. In fact a two year old needs as much iron as his or her dad! So all you dads out there, slice off a few slithers of your T-bone and share it with your toddler.

The trouble is that lots of toddlers don’t like meat. Anne-Louise Heath told us about her study of getting toddlers to either eat two meals of red meat a day (even I would find that hard) or replace their usual milk with an iron-fortified milk. It was much easier for toddlers to drink the iron-fortified milk than eat more red meat. They did manage to get the children to increase their intake from 10 grams to 25 grams of red meat a day. That’s an average of two tablespoons a day. Over the 20 week study period this ‘meat-eating’ group managed to maintain their iron stores. They were almost 30% better off than the control group (no changes made) whose iron stores dropped over the 20 weeks. But it was the iron-fortified milk group who were the clear winners. They actually increased their iron stores by a whopping 68%.

A child who drinks more than 500mLs (2 cups) of cows milk a day is more likely to be iron deficient because the milk, which is a poor source of iron, fills them up and stops them eating more iron-rich food. So this study, which has just been published in the American Journal of Clinical Nutrition, is good news for parents of milk-loving toddlers who won’t eat meat. Using an iron-fortified milk can make a real difference to your child’s iron status.

If you can’t afford iron-fortified milk here’s a few other ways to make sure your child is not one of the 1 in 6 whose iron stores are too low:

Eat fruit with meals.

Eat red meat regularly. (One predictor of iron deficiency in toddlers is eating meat less than 4 ties a week.)

Drink less than 500mLs milk a day.

Don’t give a child cows milk as a drink before 12 months of age. (Their digestive system can’t handle the large protein so well.) Stick to breast milk or formula.

Don’t exclusively breast feed past six months. A baby’s iron stores have run out by then and they need to get iron from food and/or formula.

Make your baby’s first food an iron-fortified cereal with pureed fruit

Be especially vigilant with this if your baby was premature or had a low birth weight. Iron stores are laid down in the last few weeks before birth so if your baby arrives early they have missed out on building up their iron stores.

Food-based strategies improve iron status in toddlers: a randomized controlled trial

See my other article: Brain food for toddlers

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• Iron in diet – All Information (umm.edu)
• Iron deficiency anemia – children – All Information (umm.edu)