Dr. Kim Foster: Wicked Health


Kid Not Sleeping? This May Be The Reason

A Nutritional Cause For An Age-Old Frustration

It’s an under-recognized cause of sleep trouble in kids. But it’s not uncommon. It’s nothing sexy or new-age, and it’s not a new discovery.

I’m talking about iron deficiency.

Hands up: who’s familiar with bedtime battles? Just about all of us. But I bet, for some of you, iron is at the root of those battles, and you don’t even realize it yet.

My first son, now 8, had longstanding difficulty falling asleep. For ages, I thought I was doing something wrong. I thought I needed to sleep train him. Or maybe, to co-sleep. To be tougher. To be less tough. To change our bedtime rituals...

I read book after book on the subject. Everyone has an opinion on this, am I right? I would get a knot in my stomach as bedtime approached. Until, one night a few years ago as I lay beside him, gritting my teeth and waiting for him to fall asleep as he struggled and flopped around—fighting sleep, it seemed to me—it suddenly dawned on me: he was acting exactly like a patient with Restless Legs Syndrome. But this was not something I was used to seeing in kids—it’s typically a condition that older adults get, often people with other illnesses. It’s a frustrating syndrome for many people, and can cause great difficulties with sleep. I dug out my textbooks and jumped onto my most up-to-date online resources, and discovered that, indeed, kids can get restless legs. And one of the main causes: iron deficiency. A lightbulb clicked on. Aha. Now that made sense. The kid was a super-picky eater—he hardly ever ate meat or any other dietary sources of iron.

Increasingly, we’re realizing how common iron deficiency actually is in children. We’ve always recommended iron-fortified cereals as a first solid food for infants; many people now recommend starting with meat as a first food, specifically because of the iron issue.

Does your child have low iron levels?

The only way to know for sure is to see your doctor and have a blood test done. But to give you an idea, here are some of the symptoms of iron deficiency in kids:

  • Fatigue. Especially in kids, you’d notice decreased exercise tolerance—complaints of being tired after running around or playing for a short time.
  • Pica—a peculiar phenomenon, this is when a kid develops an appetite for non-food substances like clay or paper. In particular, a craving for ice is very common in iron deficiency.
  • Pale skin.
  • Restlessness, or complaints of itchy, achy legs and feet at night.
  • Poor sleep.
  • Decreased appetite.
  • Behavioural problems, poor attention, and irritability. Reports of behaviour concerns coming back from teachers and day care.

If any of this is ringing a bell for you, you may need to take your tot to the doctor and get him or her tested for iron deficiency. If the level is low...what next?

What foods are good sources of iron?

Iron can be a difficult mineral for our bodies to absorb, but fortunately a variety of foods contain iron. A combination of these food sources works best, as some are more bioavailable than others. Pro tip: have iron-rich foods in combination with vitamin C-rich food (like oranges and tomatoes), which helps our bodies absorb the iron.

Some examples of iron-rich food:

  • Meat
  • Fish
  • Poultry
  • Nuts
  • Cream of Wheat
  • Breakfast cereals (fortified)
  • Sunflower seeds
  • Chick peas
  • Spinach

Bonus tip: try cooking with a cast-iron skillet or frying pan. This one small change will increase the iron content of foods—especially in acidic food (like tomatoes) and high-water content food.

For some kids, dietary iron may not be enough. Some kids need supplements, but this is a conversation to have with your doctor.

And while you’re thinking about iron, don’t forget about yourself. Iron deficiency in pre-menopausal women is extremely common, too, and a frequent cause for that oh-so-ubiquitous complaint of fatigue.

Next time you start worrying about hair loss—and not even from your own anemia, but from positively pulling out your hair trying to get your little angel to sleep—give a thought to your kid’s iron intake.

Once I got my son on iron supplements, his sleep miraculously improved. Of course, I then had to deal with the mom guilt of allowing him to become nutritionally deficient...but that’s a story for another time...