Zero Iron.

So I never really got around to my iron post. It got too detailed, so I gave up. I'll try to give the quick version here.

We learned after our last blood draw that Dylan has ZERO iron. Ferritin should measure at least 30, and his was ZERO. Shit. He wasn't showing any of the symptoms of anemia like fatigue or excessive paleness, but it can also cause mental delays so needless to say, I was freaking out and have learned a TON about iron in the past month or two.

Note: Pinterest is not God. My nanny told me that Pinterest said that Watermelon is high in iron. It's not. Do your research! (Or read the rest of this post.)

IRON BASICS:

Iron is really all about absorption so although some foods have a lot of iron, if it's not easily absorbed, it doesn't matter. Heme iron, mostly from meat products like beef, is the most easily absorbed. Plant sources are not as easily absorbed.

• Calcium inhibits iron absorption.
• Vitamin C aids iron absorption.

Our problem was that Dylan was eating a lot of high-fat dairy to help his weight gain. So now we focus on dairy in the morning and evening and sometimes at lunch, but snack-time is dairy free. Our nutritionist said to keep dairy about 2 hours away from iron drops. This is also why Pediatricians want toddlers drinking less than 24 ounces of milk per day. Dylan was only drinking about 12 but got lots of other sources of dairy.

This list of heme and non-heme sources is from the Cleveland Clinic

The following foods are good sources of heme iron (from animal sources): 

• Chicken liver
• Oysters
• Clams
• Beef liver
• Beef (chuck roast, lean ground beef)
• Turkey leg
• Tuna
• Eggs
• Shrimp
• Leg of lamb

The following foods are good sources of nonheme iron (from plants):

• Raisin bran (enriched)
• Instant oatmeal
• Beans (kidney, lima, Navy)
• Tofu
• Lentils
• Molasses
• Spinach
• Whole wheat bread
• Peanut butter
• Brown rice

The following chart from Harvard is even better since it lists the amount of iron in each type of food. Harvard Iron Content Sheet

PROBLEM:

Toddlers need 7mg of iron a day and babies need 10mg. Since Dylan's so small and has zero, I figure he needs at least ten. Three ounces of beef has just 2 mg of iron. It would take Dylan an entire day to eat 3 ounces of beef! So although we are trying to up the iron in his foods, he absolutely needs a supplement. (Iron supplements are typically drops.) Dylan won't drink OJ, the best iron-complement, but I found a 100% juice option that has a good amount of Vitamin C that he is okay with. I give 1ml of iron 2x a day.

So meal-time is a puzzle in our household. We try to:

1) maximize calories

2) keep dairy time away from iron time

3) add lots of vitamin C (not his favorite foods)

4) get enough fiber and water in to prevent constipation

But we are managing...

Our go to Vitamin C sources are strawberries and juice. Dylan seems to be starting to like oranges, occasionally, but they are not his favorite.

Dylan has always liked meatballs, so we are focusing on red meat more than chicken as a protein source as well as beans. But fortified cereals are actually an excellent source of iron, so Cheerios are back in the Dylan's snack cup! But like I said, getting him to take the iron drops (it's own challenge) is the most important part of our day.

Last...I learned that acid reflux medications can also inhibit iron absorption, so we tried cutting Dylan's dose in half (only morning time) and he seems to be doing okay.

Anyone else dealing with challenging nutrition issues?