Is Low Ferritin the Missing Piece of Your Child’s Sleep Puzzle?

How Addressing Low Iron Levels Could Be Key to Improving Sleep

As a Gentle Sleep Coach, I’ve worked with countless families who are exhausted, hopeless, and feeling like they’ve tried everything to help their little ones sleep. We often look at bedtime routines, environmental factors, and behavioral patterns, but sometimes the issue runs deeper. One overlooked yet crucial aspect of sleep challenges in children is ferritin—a protein that stores iron in the body. Low ferritin levels can significantly impact sleep, and this could be the missing piece of the puzzle for your child.

What is Ferritin?

Ferritin acts as the body’s iron reserve, ensuring there’s enough iron available when dietary intake falls short. Your child might have normal iron levels, but if ferritin is low, their body could struggle to access the iron it needs. This isn't just an issue for physical health—adequate ferritin levels are essential for the brain’s ability to regulate sleep effectively.

Ferritin and Sleep

Low ferritin levels can impact sleep by altering the brain's sleep architecture and causing symptoms similar to Restless Legs Syndrome (RLS). For younger children, this can present as discomfort at bedtime and difficulty settling down. I’ve seen toddlers who toss and turn, can’t stay still, and seem fussy for no apparent reason. What looks like bedtime resistance could actually be a child’s attempt to relieve discomfort caused by low ferritin.

Research shows that Restless Leg syndrome (RLS) can appear in infants, and while it's traditionally not diagnosed until the child can verbalize their discomfort, the onset of symptoms can occur much earlier (Tilma et al., 2013; Picchietti & Stevens, 2008). Children with low ferritin may wake up after only a few hours of sleep, crying, kicking, or with restlessness that makes falling back asleep impossible. This is not just frustrating for parents—it’s exhausting for the entire family.

Common Symptoms of Low Ferritin in Children

Low ferritin can be difficult to identify, especially in infants and toddlers who can’t articulate their discomfort. Here are some key signs that low ferritin might be affecting your child’s sleep:

Difficulty falling asleep: Constantly moving around in bed, seeming unable to get comfortable.
Frequent night wakings: Awake for hours during the night despite trying various soothing methods.
Extreme clinginess during sleep: Babies unable to sleep without being held or constantly nursed.
Unexplainable discomfort: Older children might describe their legs as "jumpy" or "prickly," while younger ones appear fussy without relief.

Testing for Ferritin Levels

Testing ferritin levels requires a blood draw, which can feel daunting for parents, but the process is simple and provides valuable insights. Pediatricians may often check hemoglobin levels, but it’s essential to understand that ferritin can be low even if hemoglobin appears normal. Sleep specialists generally recommend ferritin levels to be above 50 ng/mL for optimal sleep, even though the standard medical range considers lower levels as "normal."

Risk factors for low ferritin in children include:

Maternal prenatal low iron levels
Early cord clamping
Exclusive breastfeeding without iron supplementation
Family history of RLS (Tilma et al., 2013).
Child has a history of reflux, food intolerance, ADHD, or autism, they may also be at a higher risk (Kanofal et al., 2007).

Treatment and What to Expect

If your child's ferritin levels are confirmed to be low, the typical treatment involves iron supplementation under medical supervision. It's important not to attempt supplementation without guidance, as incorrect dosing can be dangerous. Most families see improvements in sleep within a few weeks of starting treatment, though it may take several months for ferritin levels to fully normalize. Additionally, gentle leg massages, warm compresses, or stretching exercises can provide temporary relief for discomfort at bedtime.

How Sleep Coaching Can Support Your Family During Ferritin Treatment

If you suspect ferritin may be affecting your child's sleep, I recommend speaking with your pediatrician about testing. Once ferritin levels are on track, we can work together to fine-tune your child's sleep routine, ensuring everyone in your home gets the rest they need.

At Blissful Baby Sleep Coaching, I believe in a child-led, compassionate approach that respects your family’s individual needs. If your child’s sleep issues seem more complicated than typical bedtime resistance, it might be time for a different perspective. Schedule a 60-minute Sleep Strategy Session today, and let’s explore how we can transform your family’s sleep.

A Helpful Tool for Your Pediatrician Visit

My Gentle Sleep Coaching colleague and researcher, Macall Gordon has studied and researched Ferritin levels and sleep. She has prepared this checklist and the accompanying PDF that you can bring to your pediatrician. Maccall is also releasing a new book on 11/19 Why Won’t You Sleep: A game changing approach for exhausted parents of non, stop, super alert big feeling kids.

This letter includes detailed information about ferritin, the connection to sleep disturbances, and a checklist of symptoms that your child may be struggling with. You can download the letter, check the symptoms that apply to your child, and bring it to your pediatrician appointment. This will help ensure a thorough evaluation and make the conversation about testing for ferritin levels smoother and more effective.

Download The symptom and risk factor checklist

For more information on ferritin and other sleep disruptors, check out these resources:

Still Wondering if I Can Help?

Please know that I do NOT advocate the "cry-it-out" method. As a certified Gentle Sleep Coach, I emphasize a guilt-free and gentle sleep coaching process that respects your child's developmental needs.

Let’s work together to restore peaceful nights for your family. Contact me today and I’ll be in touch within 24 hours with information on how to schedule your Sleep Strategy Session.

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References

Is Low Ferritin the Missing Piece of Your Child’s Sleep Puzzle?