Common risk factors for ischemic stroke in the pediatric population include sickle cell disease, coagulation disorders, arterial diseases, and varicella infection. The pathophysiology of iron deficiency anemia (IDA) leading to stroke is still not well known. There is a strong association with IDA being a significant risk factor in otherwise healthy children.  IDA occurs in approximately a quarter of the world’s infants.  It is most prevalent in patients with malnutrition or excess consumption of dairy, particularly cow’s milk. Standard practice for pediatricians is to provide anticipatory guidance on limiting cow’s milk intake, for the fact that it can lead to anemia. Although most associated with anemia, iron deficiency can present with various neurological consequences such as cognitive delay, stroke, and thrombosis to name a few.  While pediatricians provide anticipatory guidance on excess cow’s milk intake, not to exceed 12-24 ounces per day, ischemic stroke is rarely discussed as a potential risk.  We present a case series of three children who presented to our tertiary pediatric hospital with an ischemic event or venous thrombosis secondary to iron deficiency anemia stemming from excessive cow’s milk intake. There have been several proposed mechanisms regarding iron deficiency anemia association with ischemic cerebrovascular events: reactive thrombocytosis, hypercoagulation, and heart failure. Pediatricians continue to diligently give guidance on limiting excessive cow’s milk as to prevent IDA and further discuss potential neurologic effects of IDA. Surveillance is also minimized with a single assessment at 12 months of age unless there is a special circumstance. Although risk of ischemic injury is low, it is one of high morbidity and lifelong consequence.  As such, anticipatory guidance from pediatricians should include symptoms of stroke which would allow improved timing of evaluation and life changing interventions. Furthermore, iron studies should be a routine component of hypercoagulable evaluation.