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Daily versus alternate day oral iron treatment for children with nutritional iron deficiency anemia

Sinan Saylık1, Vesile Meltem Energin1, Mustafa Büyükavcı2

  • 1Faculty of Medicine, Department of Pediatrics, Necmettin Erbakan University, Konya, Turkey.

Pediatrics International : Official Journal of the Japan Pediatric Society
|February 3, 2026
PubMed

Insights

Alternate-day iron therapy is as effective as daily treatment for pediatric iron deficiency anemia (IDA). This approach offers a comparable alternative for improving hematologic and iron parameters in children with IDA.

Area of Science:

  • Pediatric Hematology
  • Nutritional Anemia Management
  • Pharmacological Interventions

Background:

  • Iron deficiency anemia (IDA) in children presents significant health challenges.
  • Daily oral iron is standard, but alternate-day dosing is explored for better compliance and fewer side effects.
  • This study compared daily versus alternate-day iron supplementation efficacy in pediatric IDA.

Purpose of the Study:

  • To evaluate and compare the effectiveness of daily versus alternate-day oral iron supplementation in treating iron deficiency anemia in children.
  • To assess hematologic and iron parameter changes between the two dosing regimens.

Main Methods:

  • Retrospective cohort study of 82 children with nutritional IDA.
  • Group 1 received daily oral ferrous sulfate; Group 2 received alternate-day ferrous sulfate.
  • Hematologic parameters (hemoglobin, MCV, RDW) and iron status (ferritin, TIBC) were measured at baseline and follow-up points (day 10, 1 month, 3 months).

Main Results:

  • No significant differences in hemoglobin changes were observed between daily and alternate-day iron therapy.
  • While the daily group showed a significant Hb increase in the first month, overall MCV and RDW values normalized similarly in both groups by month 3.
  • Ferritin and TIBC levels did not differ significantly between the treatment groups over the study period.

Conclusions:

  • Alternate-day oral iron supplementation is a viable and effective alternative to daily dosing for pediatric IDA.
  • Both regimens demonstrate similar efficacy in improving hematologic and iron parameters in children with IDA.
  • This finding supports alternate-day therapy as a potentially improved strategy for adherence and tolerability in pediatric IDA management.
Abstract

Keywords:
hematologic parametersiron supplementsiron‐deficiency anemiapediatricstherapeutics

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