Supplementing iron with medicine can be a double-edged sword

Questions answered by Doctor, Dr. Duong Ba Truc - Pediatric Center - Vinmec Times City International Hospital

According to incomplete statistics, about 20% of Vietnamese children under 5 years old are iron deficient. While the issue of malnutrition, protein, and energy is of concern to the community, iron deficiency causing anemia has not been given due attention. Iron deficiency disease or abuse of iron-containing drugs are harmful and have negative consequences on the health of children. VOV Traffic talked to an expert with more than 30 years of experience in the field of hematology in children - Dr., Dr. Duong Ba Truc - Department of Pediatrics, Vinmec International General Hospital about this issue.
Dear doctor, what are the manifestations of iron deficiency in children? If the deficiency is mild, at first, the expression of iron deficiency is short, then the child does not have any special symptoms to recognize. When the iron deficiency is prolonged, at a severe level, the most noticeable symptoms are fatigue, poor appetite, pale skin, pale mucous membranes, poor resistance to diseases; changes in fingernails, brittle toenails. Severe anemia, children also have many other manifestations such as dry hair, children often have infections, especially respiratory infections. Premature babies, low birth weight or mothers with anemia during pregnancy are very susceptible to anemia and iron deficiency.
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So what causes anemia? What are the consequences of the disease? The most common cause of anemia in children as well as pregnant women is the problem of iron deficiency or nutritional anemia
Because the baby does not have enough iron stores when born from the mother. If the mother has anemia, iron deficiency during pregnancy, the baby is very susceptible to anemia after birth. Children often have continuous infections, so their nutrition is poor, poorly absorbed, making iron in the body unusable. In addition, in our country, the rate of anemia is caused by genetic mutations, causing Thalassemia - an inherited disease that cannot synthesize globin chains in red blood cells. All the causes of long-term anemia will slow down the physical development of children. When the child has an infection, taking iron-containing medicines will not be beneficial for the child. Therefore, iron-containing medicines should not be used as they can make the infection worse. Too much iron is just as harmful as iron deficiency because iron is a heavy metal that is toxic to tissues and cells. Therefore, if children have anemia, mild iron deficiency, they should have a nutritious diet with enough iron and vitamin C.
Currently, on the market there are many drugs or products that advertise iron supplements. So the doctor can clearly tell when to take iron pills? I would like to emphasize that when children are moderately deficient in iron, they need iron supplements, but when taking iron supplements with drugs, doctors must consider it. When the child has a mild iron deficiency, it is best that the doctor should advise the child on nutrition, give iron-rich foods to absorb iron through food. In the case of children with moderate to severe anemia requiring rapid iron supplementation, the use of iron-containing drugs should be instituted, but must be evaluated through laboratory tests, the physician's experience and the actual condition of the child. Currently, some doctors have prescribed iron that is too broad in my opinion, and some places also give iron as a common tonic. That is not good because as mentioned above, an excess of iron is equally harmful as a deficiency of iron. I would like to emphasize that children with infections should not take iron supplements because it can make the infection worse.
Thank you doctor.

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