Iron-deficiency anemia (IDA) is the most common type of anemia. It occurs when the body’s iron levels drop too low to support the normal production of hemoglobin, a protein in your red blood cells that allows them to carry oxygen to your organs and tissues.
IDA is prevalent in childhood, and excessive cow milk consumption is one of the reasons. About 50% of the estimated 293 million cases of anemia in preschool children globally are due to iron deficiency.¹
Read on to learn more about the link between milk consumption and iron-deficiency anemia. We’ll also walk you through the symptoms of milk anemia, its risk factors, possible complications, and how it’s treated.
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Cow milk is a critical component of children’s diet in many parts of the world. Milk is an excellent source of calcium, phosphorus, vitamin D, and protein. However, drinking too much milk can cause numerous health complications, including iron-deficiency anemia. How does cow milk cause IDA?
One can develop iron-deficiency anemia in two ways: insufficient iron in their diet and slow, chronic bleeding in the gastrointestinal (GI) tract. Too much cow milk can lead to IDA via both mechanisms.
Infants and young children need plenty of iron as they grow, especially in neurological development. Babies typically get sufficient iron in their diet through breast milk or formula fortified with iron. The problem with cow milk is that it doesn’t contain a lot of iron.
On top of that, the iron in cow milk is poorly absorbed. The high amounts of calcium and casein in cow milk make it harder for the body to absorb whatever iron it gets from other sources. Drinking too much cow milk leaves little room for iron-rich foods, so iron levels dip and anemia sets in.
Gastrointestinal blood loss is another contributing factor to milk anemia. Too much cow milk causes small amounts of blood loss from the intestines in infants. Approximately 40% of infants have this condition.²
The risk of microscopic gastrointestinal bleeding decreases with age and stops after the age of one year. You can see that introducing your child to cow milk too early (younger than one year) or taking too much of it can contribute to iron-deficiency anemia.
Cow milk is packed with essential nutrients that may benefit your child’s health. However, cow milk is also low in iron, which infants and toddlers need because they grow quickly. Too much milk can lead to iron deficiency and further problems, including IDA.
To avoid complications such as iron-deficiency anemia, you must wait until their second year of life to introduce cow milk to your child’s diet. Avoid cow milk altogether in your child’s first year because this is when they are most susceptible to intestinal blood loss.
If you are not breastfeeding your infant, use an iron-fortified formula to prevent IDA. For children over one, limit cow milk consumption to less than 24 oz per day and ensure that they eat a well-rounded diet containing foods rich in iron and vitamin C.
Knowing what signs to look out for may be helpful if you’re concerned that your child might suffer from milk anemia.
Below, we look at some of the most common symptoms of iron-deficiency anemia in infants and young children:
Fatigue (lack of energy or getting tired quickly)
Irritability (in a way that seems out of character)
Pale skin or lack of color on the skin
Tachycardia (elevated heart rate)
A child with IDA may start eating peculiar non-edible items, such as ice or dirt
Puffiness and swollen hands, feet, and belly can also be signs of IDA in severe cases. Individuals will experience the symptoms of iron-deficiency anemia differently.
Consult a medical professional for a proper diagnosis if you suspect your child has IDA.
Undiagnosed or untreated iron-deficiency anemia may lead to serious health complications. If iron levels are significantly reduced due to excessive cow milk intake, children with IDA may experience protein loss from the GI tract. This condition is known as protein-losing enteropathy.³
While rare, this complication of IDA causes severe protein loss through the GI tract, resulting in low blood albumin—the main protein found in the blood—levels (hypoalbuminemia). Hypoalbuminemia causes fluid to leak out of the vessels into other tissues.
The leaking fluid can build up in the face, abdomen, legs, and other body parts, causing swelling (edema). The symptoms of iron-deficiency anemia and PLE resulting from excessive cow milk typically resolve after limiting cow milk consumption and adding oral iron supplements.
A doctor can diagnose IDA with a blood test. If your child is diagnosed with this condition, there’s no need to panic. Iron-deficiency anemia is typically reversible.
Specific treatment depends on the cause of the condition, severity, age, and other factors. Here are some possible treatments for milk anemia.
Milk intake restrictions—If a child is diagnosed with IDA, the first remedy a doctor will recommend is immediately reducing their cow milk intake
Iron-rich diet—A well-rounded diet containing iron-rich foods such as red meat, leafy greens, legumes, and poultry may also help
Iron supplements—A doctor may also prescribe iron supplements to increase iron levels in the blood. IV iron may be necessary in case of intolerance or malabsorption
Medicinal iron—In severe cases, patients with IDA may require higher amounts of iron to restore iron sufficiency. In that case, a doctor will prescribe iron pills
Iron is absorbed through the stomach, so interventions for iron-deficiency anemia involve nutritional changes. Luckily, iron is present in many foods and is widely available as a dietary supplement.
Iron-deficiency anemia is a condition where a lack of iron in the body affects the normal production of hemoglobin—an iron-containing protein in red blood cells responsible for carrying oxygen in your blood from the lungs to the tissues.
Iron is an essential element of various biochemical processes in the body, from oxygen transport and energy metabolism to neurological development. Cow milk contains very little iron. Excessive consumption of cow milk without iron supplementation is the leading cause of IDA in young children.
The most common symptoms of milk anemia in infants and young children are fatigue, weakness, irritability, tachycardia, and pale skin. Fortunately, iron-deficiency anemia is treatable. Treatment for IDA varies based on the cause and severity of the condition.
In the case of milk anemia, reducing milk intake immediately and adding iron supplements can reverse IDA and restore iron sufficiency. That being said, milk is still an excellent source of vitamins and minerals. Children older than one year can have cow milk as long as it’s within recommended guidelines.
Milk | Harvard T.H. Chan
Iron-deficiency anemia | Johns Hopkins Medicine
Iron-deficiency anemia | Ameican Academy of Hematology