If your child is diagnosed with iron deficiency or iron deficiency anemia, a doctor will likely recommend using an iron supplement as well as increasing the amount of iron rich foods in his/her diet. Iron supplementation can be a bit tricky in children. Let’s face it; kids can be finicky so trying to get them to eat foods that are rich in iron can be hard enough, let alone trying to get them to take an iron supplement.
Fortunately, not all iron supplements are the same and there are some pretty palatable options available to make it easier on them and you! Selecting the type and dose should be left to the discretion of a doctor or pharmacist, who will make recommendations based on your child’s specific needs. This is also important considering that iron supplements can cause side effects and even toxicity in children.
Rather than pill/capsule form, children’s iron supplements are available in suspension, syrup, drops, and powder formulations.
Oral Liquid Formulations Available in Canada
- FeraMAX® Powder (water soluble)
The iron supplements listed above are available in ferrous (Fe2+, ionic) or ferric (Fe3+, non-ionic) forms. Iron salts, which are ionic, include ferrous fumarate (Palafer® Suspension), ferrous sulfate (Fer-in-Sol® Syrup and Fer-in-Sol® Drops) and ferrous gluconate (no oral liquid formulation available in Canada). The only non-ionic option available in this market is a newer formulation called Polysaccharide-Iron Complex (PIC), which is available in Canada under the brand name FeraMAX® Powder.
All iron supplements are effective (in terms of their ability to increase hemoglobin and hematocrit); however some may taste better or be gentler on the stomach. Common side effects that occur when taking any iron supplement include: stomach upset, constipation, or diarrhea.
If you’ve ever tasted iron, I’m sure you would agree that it is just plain yucky. And if you haven’t tasted it, well, it’s not difficult to imagine the unpleasant metallic aftertaste. At one point in time you’ve probably seen a child’s reaction to an unpleasant-tasting medicine; children won’t willingly swallow an iron supplement that is not agreeable with their taste buds, which is why most brands have tried to incorporate tasty flavours.
It is always important to look at the amount of elemental iron offered by an iron supplement (the amount of iron that is available to be absorbed). Of course, there are other factors at play when it comes to absorption, which I will discuss in an upcoming article.
Here is a basic summary of the oral liquid formulations:
|Iron Supplement||Type||Dose*||Elemental Iron*||Taste||Manufacturer Recommendations|
|Ferrous fumarate||1 mL = 60 mg||1 mL = 20 mg||Cherry flavour (may stain teeth)||Administer between meals with water or fruit juice|
|Ferrous sulfate||1 mL = 30 mg||1 mL = 6 mg||Fruit flavour (may stain teeth)||Give in water or fruit juice (not milk) and preferably between meals|
|Ferrous sulfate||1 mL = 75 mg||1 mL = 15 mg||Natural flavouring (may stain teeth)||Give in water or fruit juice (not milk) and preferably between meals|
|Polysaccharide-Iron Complex (PIC)||1 tsp||60 mg/tsp||Raspberry/grape flavour (does not stain teeth)||Dissolve into warm/room temperature water or mix into soft foods or powdered cereals|
* Based on Anemia Guidelines for Family Medicine 2014 Edition
Even though the iron salt formulations (ferrous fumarate and ferrous sulfate) are flavoured, there is still an underlying metallic taste, which is not evident with PIC (this could possibly be due to the make-up of the compounds – ferrous salts being ionic and PIC being non-ionic).
For older children (ie. teenagers) who can tolerate swallowing pills and require increased iron intake, oral iron preparations are also available in tablet/capsule form. While I have been referring to the suspension, syrup, drop, and powder formulations as “iron supplements for children,” I would just like to note that these formulations can also be beneficial for other individuals such as the elderly, or those who cannot swallow pills.
Now that you are up to speed on the available iron supplements for children, I encourage you to speak with your doctor or pharmacist about these options to determine the proper type and dose for your child’s specific needs.
Content and advice provided on The Iron Maiden is for information purposes only and should not serve as a substitute for a licensed health care provider, who is knowledgeable about an individual’s unique health care needs