New Iron Deficiency Guidelines Aim to Protect Children From Brain Damage and Cognitive Delays

The American Academy of Pediatrics (AAP), the nation's leading group of pediatricians, has issued crucial new guidance to protect children and teens from iron deficiency. These updated recommendations are designed to help parents and doctors prevent severe complications, including learning and concentration issues as well as other developmental delays through improved screening, adjusted treatment protocols and dietary interventions.

Iron deficiency is a widespread problem that can affect a child's brain development and lead to fatigue and anemia. According to the National Health and Nutrition Examination Survey from 2003 to 2010, at least 15% of toddlers and 11% of adolescents are iron deficient, and the numbers may be rising. The new guidance on iron deficiency provides the following strategies and recommendations for prevention and treatment from birth through the teenage years:

• Prevention that begins at birth with the AAP recommending iron supplements for exclusively breastfed babies by four to six months of age.
• For toddlers and young children, the focus is on a diet rich in iron and limiting the amount of milk they drink, as too much milk can interfere with iron absorption.
• The guidelines highlight the importance of screening for and addressing heavy menstrual bleeding in adolescent girls, a common cause of iron deficiency.
• A once-daily oral iron supplement is effective for most infants, children and teens.

Melissa Wallach, M.D., FAAP, pediatrician at Hackensack Meridian K. Hovnanian Children’s Hospital at Jersey Shore University Medical Center, says these updated guidelines are a huge step forward for everyday pediatric care. “The 'silent' problem of iron deficiency can impact everything from a toddler's development to a teenager's ability to focus in school. The new recommendations give us a clear, preventative roadmap from birth through adolescence. It's about providing the best, most evidence-based care at every stage of childhood," she said.

"The new AAP guidelines underscore the critical window we have in early life to prevent iron deficiency anemia, a treatable threat to neurodevelopment,” said Lisa Eiland, M.D., FAAP, neonatologist and division lead of the NICU at Joseph M. Sanzari Children’s Hospital at Hackensack University Medical Center. “For pediatricians and neonatologists, these guidelines reinforce the importance of our role in initiating preventative strategies from birth. Prevention of iron deficiency in infants starts in the delivery room with delayed umbilical cord clamping for a period of at least 60 seconds.  Further, the identification of at risk infants, such as preterm and breastfed infants, allows for timely iron supplementation, laying the foundation for optimal brain and cognitive development.  These simple interventions help give every child the best possible start."

These new guidelines, written by medical experts and based on the latest scientific evidence, are designed to give parents and pediatricians the best tools to ensure children grow up healthy and thrive. Parents are encouraged to talk to their pediatrician about these recommendations and what they mean for their child's health. For information about pediatric services, visit hackensackmeridianhealth.org/en/services/childrens-health.