\documentclass{iditacard}

\leglevel{thirdleg}

\begin{document}
\begin{leg}
    \legname{River}
    \onlegspace{2}{\includegraphics[width=1cm]{icons/hypo.png}}
    \onlegspace{4}{\includegraphics[width=1cm]{icons/starve.png}}
    \onlegspace{6}{\includegraphics[width=1cm]{icons/hypo.png}}
    \onlegspace{8}{\includegraphics[width=1cm]{icons/starve.png}}
    \legeffect{\energycosts{-1}}
\end{leg}
\end{document}