The causes of ADHD (Attention Deficit Hyperactive Disorder) in children are unknown. Naturally a great deal of research worldwide is attempting to resolve this extremely worrying illness. It seems unlikely that one single ‘factor’ is at the root cause. In this article we take a brief look at the mineral Iron and the potential implications Iron deficiency in pregnancy and the early life of an infant may have.
Is there a single nutritional or environmental factor impacting on our children in respect of ADHD?
Highly unlikely as in the majority of health issues we see a combination of factors including “increased susceptibility”, which is multifactorial but the most commonly identified causes include nutritional deficiencies and exposure to environmental toxins.
Why do we struggle to find a cause for Attention Deficit in our children?
Common areas reviewed by practitioners and medical staff include childbirth, dietary intakes of the infant and early life diet, with nutrients such as iron, zinc, iodine, selenium and essential fatty acids the more commonly considered deficiencies of relevance.
Food intolerances, allergy, digestive function, exposure to lead, mercury, and pesticides are also all considered a potential link for the onset. For some children we may well be able to flag potential areas for concern, for others a more confused picture may be presenting a potential multifactorial causation of the illness.
What problems do we meet in identifying ADHD Symptoms?
- Identifying onset is frequently difficult, for example parents will often look back to a fractious colicky baby as early indications for a child subsequently diagnosed with ADHD. However we must remember that fractious colicky babies may just be that and are found in both breastfed and formula fed babies who go on to develop no long term behavioural problems.
- Testing for nutritional deficiencies is not an ideal situation as we do not want to expose young children to unnecessary blood tests.
- Identifying food intolerances can be difficult; assumptions are often made and can impact detrimentally on nutritional intake of infants if not addressed correctly.
Protecting our infants -Things to consider?
- Some infants are more susceptible toward a disturbed protective bowel flora, researchers have identified that caesarean births are associated with an altered bowel flora compared to those of a vaginal birth which can take many months to rebalance. Breastfed infants also show differing bowel flora to those of bottle fed infants.
- In addition greater focus may be required in supporting bowel flora for infants during and post antibiotic treatment.
- Prenatal exposure to toxins of mother; researchers indicate that timing of exposure to environmental toxins is important to development with ‘in utero’ risk factors identified and discussed for nicotine, alcohol, recreational drugs, PCB’s, hexachlorobenzene and glucocorticoids.
- Prenatal nutritional status of mother; in looking for nutritional deficiencies in infants we may not be looking far enough and need to look back to conception and gestational development for nutrient deficiencies with low iodine status highlighted by researchers in 2004, iron deficiency ( see below) and essential fatty acid deficiencies.
The potential implications of Iron deficiency?
The mineral Iron was routinely prescribed in pregnancy until policy changes considered that iron supplementation was not routinely required. Despite this change in policy iron deficiency is considered widespread amongst young girls and women. The Scientific Advisory Committee on Nutrition (SACN) published in 2008 ‘The Nutritional Wellbeing of the British Population’ and results included:
- Girls: ‘16% of children under 5 years and 47% of girls aged 11-18 years had iron intakes below the LRNI’.
- Women: ‘ 41% and 27% of women aged 25-34 years and 35-49 years had iron intakes below the LRNI respectively’. Iron deficiency is considered relevant for pregnant women due to expanding blood volume, demands of baby, and subsequent blood losses during childbirth.
If mothers are entering pregnancy with the typical Iron levels as identified by the results produced by the SACN then such levels throughout pregnancy and levels for the infant must be a concern. Iron levels will remain a concern for infants due to the low iron content of breast milk. When assessing infant iron intake we must take into account fortified infant formulas and foods, however the rapid growth rate of the infant and potential insufficient iron reserves may not be matched by such an intake.
What is the relevance of Iron and Attention Deficit Disorders?
Attention deficit disorders are complex and not fully understood, however one suggested association for iron intake is an imbalance in the ‘dopaminergic system’ (basically a group of nerve cells, most of which originate in the midbrain), with iron essential for modulating dopamine and noradrenalin production.
Researchers have recorded improved symptoms of ADHD following daily supplementation of iron with young children. An additional randomised controlled study for iron supplementation of low birth-weight babies found no difference in IQ to a comparison of normal birth weight babies, however they considered there was a significant effect on behaviour problems such as ADHD when assessed at 3 ½ years. Supplements ranged from zero to 2mg of iron – of the low birth weight group receiving no iron 12.7% showed behavioural issues whilst in comparison only 2.7% of the group receiving 2mg of iron evidenced behavioural problems.
Planning Pregnancy or With Child?
If you have any concerns regarding your nutritional health during pregnancy, or that of your baby you can contact your G.P., midwife or a suitably qualified health practitioner. Alternately please do contact me (Amanda) by phone or email at any time. I can also put you in touch with a nutritional practitioner in your area.