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IRON DEFICIENCY ANEMIA IN CHILDREN: DIAGNOSIS AND MANAGEMENT
Kholmatova N.O.
Andijan State Medical institute
Abstract:
Iron deficiency anemia (IDA) is the most widespread nutritional disorder among
children globally, particularly affecting those under five years of age. It can lead to irreversible
impairments in cognitive development, physical growth, and immunity if left untreated. This
article explores the etiology, clinical features, diagnostic criteria, and modern approaches to
treatment and prevention of IDA in pediatric populations. By analyzing up-to-date evidence from
medical literature, this study underscores the necessity of early diagnosis and intervention to
mitigate the long-term consequences of iron deficiency in children.
Keywords
: iron deficiency anemia, pediatrics, hemoglobin, child nutrition, micronutrient
deficiency
Introduction
Iron deficiency anemia is a significant global health concern, particularly among infants and
young children in developing countries. During early childhood, the demand for iron increases
substantially due to rapid physical and cognitive development. If the diet does not supply
adequate iron, or if iron absorption is impaired, anemia can develop. According to the World
Health Organization, nearly half of preschool-aged children in low-income regions are anemic,
with iron deficiency being the leading cause.
The physiological importance of iron lies in its role in hemoglobin synthesis and oxygen
transport. In iron deficiency, the div's ability to produce hemoglobin is compromised, resulting
in reduced oxygen delivery to tissues. In children, this can lead to fatigue, delayed psychomotor
development, behavioral disturbances, and decreased academic performance. Despite being
largely preventable, IDA often remains undiagnosed due to its initially mild and non-specific
symptoms. For this reason, healthcare providers must be vigilant in both detecting and treating
iron deficiency at an early stage.
Iron deficiency anemia (IDA) is one of the most common and preventable nutritional disorders in
children worldwide, particularly prevalent in developing countries. It is defined as a condition in
which there is a decrease in the number of red blood cells or the amount of hemoglobin due to a
deficiency of iron. As hemoglobin plays a critical role in transporting oxygen to the div’s
tissues, iron deficiency results in reduced oxygen-carrying capacity of the blood, leading to
fatigue, weakness, and impaired development.
In children, especially those under five years of age, IDA is a significant concern due to their
rapid growth and higher physiological demand for iron. During the first few years of life, iron
requirements increase dramatically to support expansion of the blood volume and development
of brain and muscle tissues. When dietary intake does not meet these increased needs or when
absorption is impaired, children are at a heightened risk of developing iron deficiency anemia.
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Globally, the World Health Organization estimates that over 40% of children under five suffer
from anemia, with the vast majority of these cases attributed to iron deficiency. This high
prevalence not only reflects nutritional inadequacies but also broader social determinants such as
poverty, poor maternal nutrition, frequent infections, parasitic infestations, and lack of access to
fortified foods or healthcare services.
The consequences of IDA in children extend beyond hematological abnormalities. Multiple
studies have linked iron deficiency with delayed cognitive development, poor academic
performance, impaired psychomotor skills, and behavioral issues. These developmental delays, if
unaddressed during early childhood, can persist into adolescence and adulthood, ultimately
impacting educational achievement and economic productivity.
Despite these serious outcomes, IDA in children often goes unrecognized due to its insidious
onset and nonspecific symptoms. Mild cases may present with pallor, irritability, or poor appetite,
while severe cases can lead to cardiovascular strain, reduced immunity, and growth failure.
Therefore, timely screening, diagnosis, and management of IDA in children are essential
components of pediatric healthcare.
Modern medicine offers effective tools for diagnosing and treating IDA, including hematological
screening tests, iron supplementation protocols, and dietary interventions. Public health measures
such as iron fortification programs and educational campaigns have also played an important role
in reducing the burden of anemia in many countries.
This study aims to provide a comprehensive overview of iron deficiency anemia in children,
including its epidemiology, etiology, clinical manifestations, diagnostic strategies, and evidence-
based treatment options. By consolidating recent data and clinical guidelines, this paper seeks to
support healthcare professionals in early recognition and management of this common yet
serious pediatric condition.
Materials
and
Methods
This article presents a narrative review based on evidence collected from scientific databases
such as PubMed, Scopus, and Web of Science. Literature published between 2015 and 2024 was
reviewed, focusing on studies related to the diagnosis, pathophysiology, and treatment of
pediatric IDA. Clinical guidelines from authoritative bodies such as the American Academy of
Pediatrics (AAP) and the World Health Organization (WHO) were also examined. Articles
involving human subjects, randomized controlled trials, and systematic reviews were prioritized
for inclusion to ensure a high level of evidence.
Results
and
Discussion
Iron deficiency in children typically results from insufficient dietary intake, increased
physiological demand, impaired absorption, or chronic blood loss. Premature infants, children
with low birth weight, and those who are exclusively breastfed beyond six months without iron
supplementation are at elevated risk. Additionally, children consuming cow’s milk in excess, or
following restrictive diets, are more likely to develop iron deficiency.
Clinically, IDA in children may present with pallor, fatigue, irritability, poor concentration, and
delayed growth. In more severe cases, symptoms may include tachycardia, systolic heart
murmurs, or even signs of heart strain. Behavioral disturbances, such as poor attention span and
restlessness, have also been associated with IDA.
The diagnostic evaluation of IDA begins with a complete blood count (CBC), revealing low
hemoglobin and hematocrit levels. Microcytic hypochromic red blood cells are a typical finding.
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Confirmatory tests include serum ferritin, which reflects iron storage levels and is considered the
most specific marker. However, ferritin is also an acute-phase reactant and may be falsely
elevated in cases of inflammation. Other useful indicators include serum iron, transferrin
saturation, and total iron-binding capacity (TIBC).
Management of IDA focuses on correcting the deficiency and addressing the underlying cause.
Oral iron therapy is the standard treatment, with ferrous sulfate being the most commonly
prescribed form. The recommended dosage is 3–6 mg/kg/day of elemental iron, administered in
two or three divided doses. Absorption is enhanced when taken on an empty stomach and with
vitamin C. Treatment should continue for at least two to three months after normalization of
hemoglobin to replenish iron stores.
In cases where oral iron is not tolerated or absorption is impaired—such as in children with
gastrointestinal disorders or those with severe anemia—parenteral iron therapy may be indicated.
Intravenous iron preparations are effective and safe when administered under medical
supervision.
Dietary counseling is crucial to prevent recurrence. Parents should be advised to include iron-
rich foods in the child’s diet, such as lean meats, eggs, legumes, and iron-fortified cereals.
Vitamin C-rich fruits and vegetables should also be encouraged to aid iron absorption.
Additionally, the excessive intake of cow’s milk should be discouraged in toddlers, as it may
inhibit iron absorption and displace more iron-rich foods from the diet.
Public health strategies play a vital role in reducing the prevalence of pediatric IDA. These
include universal iron supplementation programs for infants in high-risk populations, food
fortification initiatives, and regular screening in routine pediatric visits. Educational efforts
directed at caregivers and communities are essential for raising awareness about the significance
of iron in child health and development.
Conclusion
Iron deficiency anemia remains one of the most prevalent and yet preventable health challenges
in pediatric populations. Early detection and appropriate management are critical to avoid long-
term consequences on a child’s development. A multidisciplinary approach involving
pediatricians, nutritionists, public health authorities, and caregivers is essential to reduce the
burden of IDA globally. As research continues to advance our understanding of iron metabolism
and its systemic effects, evidence-based interventions will become increasingly effective in
ensuring that children achieve their full developmental potential.
Iron deficiency anemia remains a critical public health challenge in the pediatric population,
particularly among children under the age of five. Its high global prevalence, especially in low-
and middle-income countries, reflects not only nutritional inadequacies but also broader socio-
economic and healthcare disparities. The effects of untreated IDA during early childhood can be
profound, including irreversible cognitive deficits, delayed psychomotor development, impaired
immune function, and increased susceptibility to infections. These consequences can extend into
adolescence and adulthood, resulting in a lifetime of reduced educational attainment and
productivity.
Despite the availability of reliable diagnostic tools and effective treatment options, IDA is often
underdiagnosed and inadequately managed. Early symptoms are frequently overlooked due to
their non-specific nature, and in many cases, routine screening for iron deficiency is not
systematically implemented. As such, healthcare providers, particularly pediatricians and family
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physicians, must be vigilant in identifying at-risk populations and initiating timely interventions.
The mainstay of treatment—oral iron supplementation—remains highly effective, safe, and
accessible. However, success depends not only on clinical prescription but also on adherence to
therapy, dietary guidance, and ongoing monitoring. Equally important is caregiver education, as
many parents are unaware of the importance of iron in their child’s development or the dietary
sources that provide it.
From a public health perspective, long-term prevention of IDA requires integrated strategies.
These include nutritional counseling, routine iron supplementation for infants in high-risk areas,
food fortification programs, and targeted interventions for vulnerable groups such as premature
infants, children from low-income families, and those with chronic illnesses. Multisectoral
collaboration between healthcare providers, educators, policymakers, and community leaders is
essential to reduce the burden of IDA.
In conclusion, addressing iron deficiency anemia in children is not merely a matter of treating a
hematologic disorder—it is a fundamental investment in human capital. By ensuring that
children have the necessary nutrients for optimal growth and development, societies lay the
foundation for healthier, more productive future generations. Continued research, stronger
clinical practices, and robust public health initiatives are all vital to achieving this goal.
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