Chronic Iron deficiency in a 3yr old

[mom2tkh]

My son has had growth issues since he was born at 33wks. He weighed 4lbs 12oz. At one yr he weighed 17.5lbs, 2yrs 23lb and now he is 27lbs at 3yrs.

We figured out that he was anemic when he was a baby and started supplements. We continued the supplements until his iron was at a normal level again. He would gain great after supplementation with the iron then when we would discontinue the iron he would stop growing.

We tested awhile later, because of signs of anema and slow growth, to see that he was anemic yet again. i supplemented until his doctor said his levels were adequate. He gained again really well while on the supplements.

At his 3yr checkup in july i told his doc that i believed he was anemic again and wanted to test to see. I told him that i think the iron deficiency and slow growth are connected. His doc looked at his files and agreed with me. So we went back to GI specialist thinking it was a digestive issue.
She thinks its a milk issue but we went to an allergist who said that he believed the iron has always been the issue. He would not test for allergies because he said his history doesnt point to an allergy. She is pushing a milk free diet. She also keeps bringing up Celias's even though he has tested negative on 2 blood tests. He does have a high genetic risk for developing Celiac's but i just dont think that is our issue.

We finally got a referral to a hematologist and hopefully we will get some answers. Just wondering if anyone else has had any similar issues and how the hematology appt went.

[JaneS]

You can be intolerant of wheat and still not be positive of celiac.

Also you can be intolerant of dairy and not be IgE, the standard allergy test. IgG tests intolerances, but that is not always correct either. The gold standard is eliminate strictly and then reintroduce after a good amount of time, several months.

Does he have other digestive symptoms? Other health symptoms?

[mom2tkh]

He has had softer stools than most normal toddlers from the time he quit nursing. (15mo) He still has stools that fall apart when they hit the water in the toilet.
His GI doc did say that if we cant figure something out that our next step will be a gluten free diet to see if that helps. He had a scope a few months back that showed shortened villi but it was inconclusive what caused it. She wants to eleminate dairy and maybe go back in and do another scope to see if the damage has healed.
He has never had blood in his stools even occult blood. We have tested many times thinking that blood loss was causing his iron issues. There is no other problems pointing to an allergy which is why an allergist wouldnt even test him for the major allergens. He said that he is not showing any symptoms of an allergy.

I am just ready to speak with the hematologist to see if there is an issue with his blood or his bone marrow that keeps it from maintaining a healthy iron stores. He does great while on supplements but as soon as we stop them his iron stores drop rapidly.

[sbgrace]

Is he getting his RDA amount of iron (what form/what foods?) every day?

I have to make sure my son gets the RDA or a little above every day or he does drop low. He's not a red meat eater so diet isn't a good source for him (eggs, prunes, spinach, nuts/seeds, etc. all inhibit iron absorption). So we supplement with an amino acid chelate form (ferrochel also called ferrous bisglycinate) daily just at RDA or slightly above.

Here is my take on this. I think most kids are ok with iron because the typical kid is eating foods (cereals, breads, breakfast bars, etc.) that are fortified with iron. My kids aren't eating those types of foods because of our diet choices. So if the iron isn't in the diet they are going to get anemic. As I indicated most foods outside of red meats aren't good sources are are worse than not good (as in inhibit). Further, a child would have to eat a lot of red meat to get their daily iron. So for us we have to supplement.

[mom2tkh]

I have no doubt that he probably doesn't get the RDA because he has no appetite without supplements. While on the supplements he will eat good meals but as soon as we get his iron good and stop supplementing he quits eating.
He had had growth issues from birth and I feel like his iron has always been the issue. I am still waiting on a call from the hematologist to even make an appt. I was giving him flinstones vitamins when we stopped the concentrated iron supplements.