At a recent Provider Relations CME Lunch and Learn sesssion, Dr. Melissa Mark — pediatric hematologist/oncologist at CHKD — shared insights on iron deficiency in children. Explore why it’s important and discover practical strategies for managing it in both primary and specialty care in the recap below.
Why Iron Deficiency Should Be a Priority
Iron deficiency remains one of the most common nutritional problems in pediatrics, with significant implications for growth, neurodevelopment, and overall health. Early recognition and intervention at the primary care level can prevent complications and reduce referrals for advanced care.
Practical Management Strategies
Dr. Mark shared a structured approach to managing iron deficiency before referral:
- Confirm the Diagnosis:
Always check a full panel of iron studies to include a reticulocyte count and ferritin. - Counsel Families:
Emphasize the impact of iron on brain development and IQ — this helps families understand why adherence matters. - Trial of Oral Iron:
Most cases respond well to oral supplementation when adherence is consistent. Non-adherence is far more common than malabsorption. Counsel families on strategies to improve adherence, such as giving iron in the bathtub to avoid staining clothes.
Dietary Tips:
Encourage iron-rich foods early on during complementary feeding. Calcium rich foods like milk can interfere with iron absorption in food and with supplements.
IV iron should be reserved for specific situations:
- Need for rapid correction due to clinical severity
- Documented intolerance after a good oral trial
- Ongoing blood loss or absorption issues (rare)
- Inflammatory bowel disease or other chronic conditions
IV iron is not without risks; anaphylaxis, intolerance, and even skin tattooing from infiltrates have been reported. Most patients can be managed without hospitalization. Please call our team before sending a child to the ED for iron deficiency anemia. We can often arrange clinic visits within 24–48 hours.
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