Iron Deficiency Anemia (IDA)

Anemia is a condition when there are too few red blood cells in the body.

Iron deficiency anemia (IDA) is one type of anemia where there is not enough iron in the blood to help the body make red blood cells.

The main job of red blood cells is to carry oxygen from your lungs to all the organs and tissues in your body. A red blood cell is full of a protein, called hemoglobin, which carries the oxygen. Iron is an essential part of hemoglobin. Iron is needed to help make hemoglobin and to help carry oxygen.

When people lack a sufficient amount of iron, fewer red blood cells are made and each red cell has smaller amounts of hemoglobin. As a result, people who are iron deficient can become very anemic. Iron deficiency is very common in young children because of poor intake of iron rich foods. Iron deficiency is also very common in teenage girls because of blood loss with menses. 

Many people with mild anemia do not have any symptoms. As the anemia becomes more severe, a person may experience some of these symptoms:

  • A feeling of weakness or fatigue
  • Pale skin
  • Headache
  • Fingernail changes
  • Cold hands and feet
  • Fast heartbeat
  • Unusual shortness of breath
  • Possible affects on child development and academic performance

Anemia is diagnosed with a blood test. A doctor may also look for hidden blood in the stool.

Low iron levels cause iron deficiency anemia. Low iron levels can be the result of:

  • Diets low in iron: This is common in children who do not eat enough iron-rich foods, drink excessive amounts of cow’s milk and eat excessive amounts of junk food. In addition, people who follow "fad" diets can develop IDA. The idea that infants receive enough iron from regular milk is a common misconception. Infants need either iron-fortified formula or breast milk to receive necessary amounts of iron.
  • Growth spurts: Children under age 3 grow so fast that their bodies have a difficult time keeping up with the amount of iron they need if their diet is poor in iron.
  • Pregnancy: Women who are pregnant or who are breastfeeding require higher than normal levels of iron. Premature babies need more iron than other infants.
  • Blood loss: Blood loss can be related to heavy periods or internal bleeding such as in the GI tract or urine. 

Treatment for IDA depends on the cause of the anemia. For example, if an individual is anemic because their diet is low in iron, a doctor may recommend an iron rich diet and oral iron (pills or liquid) or IV Iron. If the anemia is a result of blood loss, the patient will be treated with iron but may also need to be seen by another specialist to find the source of the bleeding or to control a woman’s menstrual periods. Some patients with severe anemia may require a blood transfusion.

If the doctor recommends iron supplements, remember:

  • Iron supplements can cause an upset stomach and may change the color of stool (black and tarry).
  • To increase absorption, they should be taken on an empty stomach or with orange juice. However, iron supplements can irritate the stomach and may need to be taken with food.
  • Iron supplements can cause constipation; consequently a stool softener or laxative may also be prescribed.

If the doctor suggests an iron rich diet, it may look something like this:

Foods Rich in Iron 

Meat SourcesServing SizeIron (mg)
Clams, small924
Tofu, firm and raw½ cup13
Pistachio1 cup8.7
Oysters3 ounces5.7
Pinto Beans1 cup4.5
Kidney Beans1 cup3.2
Garbanzo / Chickpea1 cup3.2
Beef3 ounces2.3
Almonds1 ounce1.0
Chicken3 ounces0.9
Egg 1 whole0.6
Fruits and VegetablesServing SizeIron (mg)
Peaches, dried10 halves5.3
Prunes, dried102.1
Raisins⅔ cup2.1
Avocado1 medium2.0
Tomato Juice6 ounces1.1
Broccoli½ cup0.7
Green Beans½ cup0.6
Grain ProductsServing SizeIron (mg)
Total Cereal, General Mills¾ cup18
Cream of Wheat¾ cup9.1
Cheerios Cereal, General Mills1 cup8.1
Spaghetti1 cup2.0
Bread, Whole Wheat1 piece1.3

Recommended Daily Iron Intake

* American Academy of Pediatrics, Pediatric Nutrition Handbook, Fifth Edition, 2004. 

0-12 months2 - 4 mg per kg per day
1-2 years old7 mg per day
3-8 years old10 mg per day
9-13 years old8 mg per day
14- to 18-year-old males11 mg per day
14- to 18-year-old females15 mg per day

  • Have at least one iron-rich food with each meal.
  • Take the iron supplement with 2 ounces of a vitamin C-rich juice like orange or tomato.
  • Prepare meals which contain iron from animal sources as well as from plant sources.
  • Avoid drinking tea and coffee with meals rich in iron because components in these beverages can decrease iron absorption.
  • Use antacids sparingly.

Other Considerations

  • Cow's milk and fruit juice are poor sources of iron and may displace iron-rich foods.
  • Your doctor may recommend no milk for two to three months; otherwise drink no more than 8 ounces of milk and 8 ounces of fruit juice daily.
  • Consume two to three servings of dairy, for adequate calcium, like cheese and yogurt.
  • If your doctor recommends it, drink one to two cans of PediaSure (or an equivalent) daily because it contains iron and calcium.

Last Updated 03/2016