This deficiency can result from various factors, including inadequate dietary iron intake, poor iron absorption, or blood loss

Iron Deficiency Anemia

Dr. Jennie Berkovich

It’s common for babies to get routine bloodwork done around their first birthday. In our office, we typically check lead levels as well as hemoglobin. Hemoglobin is a protein containing iron that transports oxygen from the lungs to other tissues in the body. Iron deficiency anemia (IDA) occurs when the body lacks sufficient iron to produce adequate hemoglobin. This deficiency can result from various factors, including inadequate dietary iron intake, poor iron absorption, or blood loss.

In otherwise healthy toddlers, the most common cause of iron deficiency anemia is due to nutrition. It’s common to have too much milk intake, which often results in a toddler not wanting to eat other foods. In addition, milk can interfere with proper iron absorption.

The primary source of iron comes from:

• Iron-fortified cereals
• Lean meats, poultry, and fish
• Beans and lentils
• Dark-green leafy vegetables

Unless your one-year-old is munching on kale (and if they are, teach me your tricks!), it’s likely they’re not getting enough iron from foods. Because this type of anemia develops over time, the symptoms can be very subtle (or completely absent). Things to look for include:

• Pale skin, especially noticeable around the hands, nails, and eyelids
• Fatigue and weakness
• Poor appetite
• Rapid heartbeat or heart murmur
• Dizziness or lightheadedness
• Developmental delays and behavioral problems
• Headaches
• In severe cases, children may develop pica, an unusual craving for nonfood items like dirt or ice.

Treatment for iron deficiency anemia primarily involves iron supplementation. Oral iron supplements are the most common form of treatment, typically prescribed for three to six months. There are many brands available, so it’s worth finding one that works for your family (both from a kashrus standpoint and one that won’t irritate the tummy).

It’s also crucial to administer iron supplements correctly:

Give on an empty stomach or with a small amount of food for better absorption.

Avoid taking with milk or caffeinated drinks, which can interfere with absorption.

Combine with vitamin C-rich foods (like orange juice) to enhance absorption.

In severe cases or when oral supplements are ineffective, intravenous iron or blood transfusions may be necessary.

Teenage girls and young women are also at risk for iron deficiency anemia. While the cause isn’t usually due to nutrition, the treatment is still iron supplementation for several months.

Prevention of anemia in all populations includes having a balanced diet and making an effort to include nutritional sources of iron. Iron deficiency anemia responds beautifully to iron supplementation and most of the time, the iron can be stopped after several months.

Not all anemia is due to iron deficiency and not all iron deficiency is due to nutrition. However, anyone with weakness, pallor, or a sudden decrease in energy levels should check their iron levels. Long-term iron deficiency can result in neurologic changes, delays in development, cognitive impairment, and place stress on the cardiovascular system.

As a former patient with anemia, I’m very makpid about screening my toddler and teenage patients for this thankfully very treatable, but often-missed condition.

Pass the kale, please!

Dr. Jennie Berkovich is a board-certified pediatrician in Chicago and serves as the Director of Education for the Jewish Orthodox Medical Association (JOWMA)

Choose Your Label Wisely

Hadassah Eventsur

Many late-diagnosed women can recall the exact moment they received their ADHD diagnosis. Some are still flooded with a feeling of intense relief as the shards of childhood memories form a mirror of self-awareness.

Others can still sense their hair standing on end, as their thoughts are hijacked by the dreaded word: label. They frantically try to explain it away by saying they just need more cleaning help or self-care.

Whether you’ve accepted or rejected the “label” of ADHD, one thing is universal. When women struggle, they tend to wholeheartedly accept other labels such as “lazy” and “stupid” without question. For some reason, they believe that by berating and degrading themselves, they are taking responsibility for their behaviors and actions. But do they ever stop to analyze the validity of these labels?

What if learning about ADHD can help you shed the harmful or false labels you’ve given yourself? Perhaps you’re not lazy, but you struggle with emotional regulation or decision fatigue. Maybe you are not stupid, but your working memory has limitations with retaining information for short-term use.

Whether or not you accept an ADHD “label” as true, one thing is for certain. Be choosy about the labels you do accept wholeheartedly. Mislabeling only leads to pain and stagnation, and the path to growth is paved with self-awareness and compassion.

Hadassah Eventsur, MS, OTR/L is a licensed occupational therapist with over 20 years of experience, and a certified life coach in the Baltimore, MD area.

Summer SAD

Sarah Rivkah Kohn

There is a lot of awareness around winter SAD (seasonal affective disorder) where people struggle with sad and often depressive thoughts due to the lack of sunlight.

But did you know that while 90 percent of SAD sufferers only suffer in the winter months, ten percent suffer only in the summer months?

Why do some people feel more depressed in summer? Unlike winter SAD, which is related to a lack of sunlight, experts are still researching the causes of summer SAD. Some of the possible causes are: a disruption of routine, which can awaken anxious and depressive feelings; the heat, which brings on both physical and emotional pain. Another possibility is that some go on extreme diets in the summer because of body image fears. The combination of that stress and nutrient mess-ups can also be a factor.

Symptoms of summer SAD often include loss of appetite, trouble sleeping, weight loss, and anxiety. If you feel this way, talk to a doctor or therapist. Sometimes the practical changes you make (routine, food, exercise, sitting out of the heat) are all you need. Other times, it’s not enough. Waiting it out simply makes it harder to shake it off or treat three to four months later.

Sarah Rivkah Kohn is the founder and director of Links Family, an organization servicing children and  teens who lost a parent.

(Originally featured in Family First, Issue 903)