My 3.5 year old baby has thalassemia major with 3000 ng/ml ferritin. Please suggest food advise.

Hello,

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Based on your query, my opinion is as follows:

Iron intake should be reduced. Vegetarian diet will be better as iron content is low. The diet that can be followed include:

1. Importantly avoid vitamin C or citrus food up to four hours after food as it helps in improving iron absorption.

2. Reduce nonvegetarian diet, try to maintain the intake of iron from the overall diet to less than 18 mg per day.

3. Cereals like wheat bran, maize, oats, rice, and soya are helpful. Not sure if she takes, but tea and coffee or even milk during meals will reduce iron absorption.

4. Dairy products like milk, cheese and yogurt which reduce iron absorption, particularly with meals. Make sure, all are non-iron fortified.

5. For the diet, I would recommend cereals, particularly rice, oats or maize along with tea (2 cups). You can vary the diet based on taste.

6. If difficult multivitamin supplementation without an iron will be very helpful with cereals based diet including soy protein.

7. Hemoglobin at all times above 10 g% and formation of donor pool is necessary. Regular chelation therapy to avoid iron overload is necessary.

Very high iron sources are found in the following foods; they should be avoided or eliminated from the diet: like - Proteins that should be avoided or eliminated from the diet: oysters, liver, pork, beans, beef, peanut butter, tofu.

The grains that should be avoided or eliminated from the diet: flour tortillas, infant cereal, cream of wheat, Malt-O-Meal, and cereals, such as Most, Product 19, Total, Kix, All Bran, Life, Raisin Bran, Special K, 100% Bran, Rice Chex, Rice Krispies, Cornflakes, Wheaties, etc.

The fruits and vegetables that should be avoided or eliminated from the diet are prune juice, prunes, watermelon, spinach, leafy green vegetables, dates, raisins, broccoli, peas, fava beans, etc.

Managing a child with thalassemia is an ongoing job. Try to maintain a good body mass index and hemoglobin should be always above 10g%. Most importantly, try to form a donor pool for regular blood donation from a group of friends or non-related relatives with the same blood group to reduce the risk of antibody formation and also infections. If not sure, contact a transfusion medicine consultant, he will be able to help you more. Ferritin is too high and iron chelation is necessary. Do discuss with your doctor.

I hope this helps.