Iron deficiency alert: Are you and your family getting enough? Why this nutrient matters more than you think.
If your child fusses, gets irritable, or struggles to sleep, or if you’re a parent running on empty, iron deficiency could be the missing piece of the puzzle.
With 25 years as a clinical dietitian, Dr Libby Weaver knows how often families overlook this vital nutrient. In her new book, Fix Iron First, she explains why iron plays a crucial role in growing bodies and brains, how deficiency appears differently at each stage of childhood and adolescence, and why mums especially need to watch their iron levels.
We sat down with Dr Libby to explore the key signs, challenges, and solutions every parent needs to know.
Iron deficiency in families: What every parent needs to know
Why did you feel now was the right time to write Fix Iron First?
I actually set out to write about something else entirely. But 62,000 words in – 11,000 of which were about iron – I felt compelled to shift focus. Iron has always been front of mind throughout my 25+ years of clinical practice, and I’ve long believed it’s under-appreciated for far more than just energy.
It’s essential for mood, with low levels linked to anxiety and depression. It’s vital for thyroid function, detoxification and countless biochemical processes. It is the most common nutritional deficiency in the world, particularly among women across the menstruation years, pregnant women, teenage girls, athletes, and sadly a growing number of toddlers and children. Yet, it’s not getting the attention it needs to alleviate the unnecessary suffering it causes – other nutrients have become ‘trendier’ and we’re missing iron deficiency. There are very few systems in the body that aren’t impacted by low iron – and that’s a conversation we need to bring to the forefront.
Parents often sense something’s “off” with their child – fussy eating, poor sleep, emotional outbursts – but don’t think to check iron. Why is it such a key piece of the puzzle?
Iron is vital for growing bodies and developing brains. It’s needed for oxygen transport, energy production, immunity and the production of mood-regulating neurotransmitters like dopamine (motivation) and GABA (calming).
It’s becoming increasingly common for women to go through pregnancy iron deficient, which means many babies are born with low iron stores. Breastmilk contains virtually no iron, and while formulas tend to be fortified, calcium can block iron absorption. A baby born to term has accumulated iron in the liver over the third trimester of gestation and also draws from its mother – and if those are low, the baby’s reserves may not last the 6 months they are supposed to before complementary foods are started.
Premature birth and low birth weight are other factors that contribute to inadequate iron stores at birth. Couple this with a lack of awareness around babies from 7-12 months of age requiring 11mg of iron per day, and how important it is to introduce iron-rich foods as soon as solids are started and you can see how easily iron deficiency can develop in those early months. The Kids Research Institute found that one-third of one-year-olds and up to two-thirds of three-year-olds in WA have low iron. It’s likely similar elsewhere in Australia – and that’s deeply concerning.
It can be hard to tell the difference between behavioural or developmental concerns and something biological like low iron. What early signs should parents look out for?
Iron deficiency isn’t the only cause of developmental or behavioural issues – but it’s one that’s often missed. When I worked as a dietitian, I saw many children whose symptoms pointed to low iron, even without a blood test. A pattern often emerged, usually with three or more of the following:
- Has a pale face (can have an almost translucent appearance if the deficiency is severe), sometimes with visible veins on their face or a bluish tint in the whites of their eyes
- Has a poor appetite or is a very selective eater
- Avoids meat, even when offered regularly
- Has a tendency to be irritable, easily agitated or restless
- Has trouble concentrating or staying focused
- Has a rapid heart rate at times when it’s not warranted
- Experiences shortness of breath quite easily with activity
- Might have times of irregular, rapid breathing (body trying to transport more oxygen)
- Shows slower physical growth or developmental progress
- Has pale gums or inner eyelids when gently pulled down
- Drinks more than 500 ml of cow’s milk daily (this can interfere with iron absorption and/or crowd out iron-rich foods)
- Gets frequent colds, infections or is often unwell
- Has a tendency to have cold hands and/or feet, unrelated to the weather
- Eats or craves non-food items like dirt, clay, sand, ice, paper or paint (a condition known as pica; this is more common in very young children)
- Delayed puberty (teenage boys).
How does iron deficiency show up differently in toddlers, school-aged children, and teens?
While the symptoms often overlap, they can present differently with age.
- Toddlers: Look for fussy eating, recurrent infections, easily agitated/irritated and sleep issues.
- School-aged children: Trouble concentrating and continued picky eating may become more noticeable or pronounced. One UWA study found that 1 in 4 children with ADHD-like symptoms had a history of iron deficiency.
- Teens: Moodiness, anxiety and irritability may be chalked up to hormones – but it’s worth asking whether low iron could be contributing. Heavy periods are a common cause in teen girls.
Sleep issues have so many causes – how does low iron affect a child’s ability to fall or stay asleep?
Iron plays a critical role in the production of melatonin, the primary hormone that allows us to fall asleep and stay asleep. Without adequate iron available, melatonin production can be compromised leading to poor sleep quality. Low iron is also a driver of restless legs and sleep-disordered breathing in children. If a child has trouble settling at night, frequently wakes or seems tired despite sleeping, checking iron status is a worthwhile starting point.
We often link iron to tiredness, but how else can it affect a child’s brain development, learning, or emotional regulation?
We tend to associate iron with energy – but its role in brain development and emotional wellbeing is just as critical. A study published in the British Medical Journal highlights a consistent global finding: children who experience severe, chronic iron deficiency in infancy tend to have poorer cognitive performance and lower achievement in school.
The authors suggest this is because iron is essential during key windows of brain growth and development – and that a deficiency during these critical periods may lead to lasting changes that are difficult to reverse. While socioeconomic and psychosocial factors also play a role, the biological impact of low iron during early development is profound and well-documented.
Teen girls are especially at risk. What signs might suggest low iron, especially when mood swings and fatigue are often blamed on hormones or school stress?
It’s true that teenage girls face a perfect storm when it comes to iron deficiency. The combination of the onset of menstruation, rapid growth, increased academic and social demands – and often limited iron intake – can easily tip the balance.
The challenge is that many of the early signs of low iron overlap with what’s often considered “normal” teen behaviour: tiredness, mood swings, low motivation, anxiety, trouble focusing. But if these signs persist or intensify, it’s worth taking a closer look. A simple blood test can offer clarity, and addressing low iron can dramatically improve energy, focus, mood and overall resilience during these important developmental years.
Many mums assume it’s normal to feel foggy, exhausted, and flat. How can iron deficiency impact their ability to cope and parent?
Motherhood is demanding at the best of times — emotionally, mentally and physically. However, there’s a point where “normal” fatigue may actually signal something deeper, like iron deficiency.
Iron is essential for more than just energy. It plays a crucial role in brain function, mood regulation, immune health and even your ability to handle stress. When iron levels are low, mothers may experience not just physical exhaustion, but also mental fog, low mood, irritability and a shorter fuse – all of which can make day-to-day parenting feel overwhelming. Tasks that once felt manageable can start to feel insurmountable. The constant decision-making, emotional labour and multitasking that parenting requires becomes harder to sustain. You might feel less patient, less present and less like yourself.
Because these symptoms often creep in slowly, many women accept them as part of life – especially after having children. Yet, they’re not just a natural consequence of motherhood. Often, they’re a signal from the body that something needs attention. And when iron levels are restored, many women describe it as “getting themselves back”. That renewed energy, mental clarity and emotional steadiness can make a profound difference – not just in how they feel, but in how they parent and connect with their family.
How serious can iron deficiency become if left untreated, not just in mums, but across the whole family?
Iron deficiency may start quietly, but if left unaddressed, it can have serious consequences for every member of the family. Remember, it doesn’t just affect energy levels – it impacts mood, concentration, immunity, sleep, thyroid hormone production, physical development and emotional regulation. Over time, the effects can ripple through family life in subtle but significant ways.
Left untreated long-term, iron deficiency can progress to iron deficiency anaemia – a more severe form where red blood cell production is compromised. This can lead to heart palpitations, breathlessness, dizziness, and in some cases, more serious complications like heart strain or complications in pregnancy.
Because the symptoms can be so varied – from foggy thinking and fussy eating to frequent infections or emotional agitation – it’s easy to miss the common thread. But when iron deficiency is identified and treated appropriately, the changes can be life-changing. And in the grand scheme of things, it’s a simple fix. For many families, it’s not just about correcting a nutrient gap – it’s about reclaiming wellbeing, resilience and quality of life.
Finally, if there’s one takeaway you hope parents get from this book, what would it be?
You don’t have to accept feeling tired, foggy, forgetful or flat as just part of modern life – or part of being a parent. Yes, there will be sleep-deprived nights and seasons that stretch you physically and emotionally. But if you’re not bouncing back… if exhaustion, low mood or mental fatigue have become your norm… please don’t dismiss it as “just the way it is now”.
Your body is always communicating with you. When you tune in and listen with curiosity and compassion, you may uncover something simple – yet powerful – like iron deficiency, quietly affecting your energy, focus, emotions and resilience. My hope is that Fix Iron First helps you join the dots. That it gives you the insight and confidence to ask the right questions, seek the right tests and advocate for your wellbeing – and your family’s. Because when your iron is truly restored, it can change everything.