A checklist of signs and symptoms of iron deficiency in children

As a parent or caregiver, it can be hard to know whether your child’s tiredness, picky eating or irritability is just part of growing up – or a sign of something more. One of the most commonly overlooked causes of these symptoms in kids is iron deficiency.

Iron is essential for growing bodies and developing brains. It is essential for oxygen transport (hence energy), immune function and even the production of mood-regulating neurotransmitters like dopamine (motivation) and GABA (calming). But the truth is, many children simply don’t get enough dietary iron to meet their requirements and the signs can be easy to miss or attributed to other things.

When I was working as a dietitian, I saw countless children with low iron levels. Some came with confirmed blood test results. Others showed a clear pattern of symptoms – not always all of them, but often a cluster of three or more.

Here’s a checklist of what I would look out for and chat to the parents about to identify if iron deficiency might be part of a child’s health picture: 

• Has a pale face (can have an almost translucent appearance if the deficiency is severe), sometimes with visible veins on their face or a bluish tint in the whites of their eyes

• Has a poor appetite or is a very selective eater

• Avoids meat, even when offered regularly

• Has a tendency to be irritable, easily agitated or restless 

• Has trouble concentrating or staying focused

• Has a rapid heart rate at times when it’s not warranted 

• Experiences shortness of breath quite easily with activity

• Might have times of irregular rapid breathing (body trying to transport more oxygen) 

• Shows slower physical growth or developmental progress

• Has pale gums or inner eyelids when gently pulled down

• Drinks more than 500 ml of cow’s milk daily (this can interfere with iron absorption and/or crowd out iron-rich foods)

• Gets frequent colds, infections or is often unwell 

• Has a tendency to have cold hands and/or feet, unrelated to the weather

• Eats or craves non-food items like dirt, clay, sand, ice, paper or paint (a condition known as pica; this is more common in very young children)

• Delayed puberty (teenage boys).

No child needs to tick every box – but if you’re noticing a pattern of three or more, a degree of iron deficiency is more likely. Some parents choose for their child to do a blood test while others prefer to be guided by these symptoms.

Supplementing with a gentle, food-sourced iron formula at doses within the recommended daily intake for your child’s age can offer noticeable benefits, especially when symptoms are present. In many cases, parents report a visible shift in mood, energy, appetite and resilience within just a few weeks.

Iron deficiency is common, but it’s also correctable. With the right support, your child’s energy, focus and confidence can be restored.