How much do you know about infants and iron? Did you assume that your baby is covered for iron because baby formula and baby foods are fortified? Or perhaps you thought that since you are breastfeeding your baby it’s something you don’t have to worry about. After all, you might have thought, everyone knows that breast milk is the perfect food for infants.

If you thought your baby was safe from iron deficiency and iron deficiency anemia, you may be surprised to learn that the American Academy of Pediatrics (AAP) suggests babies be tested for iron levels and anemia at the age of 12 months. This most recent recommendation was issued as part of new guidelines for the prevention of chronic neurodevelopmental issues. The theory behind this recommendation is that neurodevelopment and behavioral problems take a long time to emerge in response to iron deficiency. In fact, such issues may not show themselves until a decade or two after treatment for the anemia.

The effects of anemia are just that long-term.

For this reason it was decided that babies should at the very least, be screened for iron deficiency at the age of one year. The AAP report also recommended that babies be given iron supplements from the age of 4 months. And this is where things become controversial.

The AAP bases its recommendation on the fact that in a healthy, normal pregnancy, a baby receives reserves of maternal iron during the final trimester of the pregnancy. These iron reserves cover a baby during the first 4 months of his life. Knowing this, the AAP feels that babies should receive iron drops at this point, so as not to risk developing an iron deficiency.

Then too, the AAP recommends that babies be exclusively breastfed for the first 6 months. Breast milk contains little iron, lending strength to the AAP recommendation for beginning iron supplements at 4 months, when infant reserves of iron begin to dwindle. The iron that is in breast milk, however, is very well-absorbed by infants, in part because breast milk also contains vitamin C which aids in the absorption of iron.

Proponents of breast feeding say that breast milk contains minimal amounts of iron (compared to formula) for good reasons. Babies simply don’t need much iron to fulfill their requirements. Too much iron, say the breast feeding experts, is not “better” than an iron deficiency and can be detrimental to an infant’s health. The iron in breast milk, say the breast milk pundits, is sufficient for the baby’s needs.

It’s important to note that while a baby’s iron stores begin to peter out at 4 months, this doesn’t mean that poof! The iron suddenly disappears. It’s more of a gradual process and nutritionists believe that babies are generally covered for iron requirements until the age of 6 months, whether breast or formula-fed. Even at the 6 month mark, the baby’s need for iron is easily met by the addition of iron-rich solid foods (as opposed to iron supplements).

In the case of formula-fed babies, iron is obtained through the fortification of formula with iron. Infant nutritionists regard the AAP’s recommendation regarding the addition of iron supplements at 4 months as a matter of unnecessary caution. The concern of the nutritionists is that as a result of following the AAP recommendation, a baby may end up with excess iron in his system.

So what’s a parent to do? To whom should a parent listen? It used to be felt that parents could rely on the opinion of the medical establishment. But in today’s world of better parenting education, not to mention Google, a parent now has the option to explore the topic in detail and make his or her own decision regarding infant nutrition. That said there are risk factors that could predispose an infant to iron deficiency anemia.

Risk Factors That Predispose Babies to Iron Deficiency Anemia:

• Premature babies—this is true because the baby’s iron reserves are built up during the final three months of the pregnancy. If the baby is born before term, his iron reserves will be lower that than of a term baby and will require supplementation at an earlier stage.
• Low birth weight babies
• Poor maternal nutrition during pregnancy
• Maternal diabetes

How much iron does a baby need?

Recommended Dietary Allowance (RDA) for Iron:

• Infants 0-6 months: 0.27 milligrams per day is considered adequate intake (AI)
• Infants 7-12 months: 11 mg. (AI)
• Children 1-3 years: 7 mg. (AI)

Once solid foods are introduced, at the age of 6 months, iron needs can easily be met with even small amounts of iron-rich foods. Here you can see how much iron is contained in a single tablespoon of these foods commonly fed to infants (based on the approximate measure of 14.23 grams in 1 tablespoon).

Amount of Iron in 1 Tablespoon of these common baby foods:

• Beef .36 mg
• Broccoli .09 mg
• Chicken .15 mg (light meat) .19 mg (dark meat)
• Egg Yolk .38 mg
• Sweet Potato .10mg

Foods Rich in Iron:

• Beans
• blackstrap molasses
• Breast Milk
• brewer’s yeast
• Broccoli
• dried fruit (apricots, figs, prunes, raisins)
• egg yolks
• grains (bran, breads, brown rice, cornmeal, farina, iron fortified cereals kasha, millet, quinoa, wheat germ)
• greens (broccoli, collards, kale, spinach,)
• Iron-Fortified Infant Formula
• meat & poultry (beef, beef & chicken liver, pork, turkey, chicken)
• mushrooms
• prune juice
• shellfish (with consent of pediatrician)
• sweet potatoes
• tofu
• tuna, sardines, canned salmon
• winter squash

Foods rich in vitamin C aid in the absorption of iron.

Foods Rich in Vitamin C:

• Apples
• Bananas
• Berries
• Citrus fruits
• Green vegetables
• Peaches
• Tomatoes

 

 

 

 

 

 

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