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Is Your Baby Iron Deficient?

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Babies PlayingThe American Academy of Pediatrics estimates that 6.6%-15.2% of children in the U.S. are iron deficient. Is your baby one of them?

Since the 1970s, the rates of iron deficiency and iron deficiency anemia have declined due in part to iron-fortification of infant formula and foods, yet both of these conditions remain very prevalent in the United States with a peak incidence occurring between 9-24 months of age.

Children at this age need an adequate iron supply to support their rapid growth rate and increased blood volume. Screening occurs between 9-12 months of age and again at 15-18 months of age, however, many

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iron deficiency conditions are missed. Couple that with poor follow-up treatment for those conditions that have been diagnosed, children could be set-up for long-term health issues affecting growth and development due to iron deficiency. Iron deficiency can also increase lead absorption thereby increasing lead concentration in the blood stream which can lead to other developmental delays.

Much of a fetus’s iron storage occurs in the third trimester of pregnancy, therefore, babies born prematurely have less exposure to iron and less time to develop an ample storage. Maternal complications can also affect the availability of iron in both term and preterm infants. Healthy, term infants have enough iron stores until approximately 4-6 months of age. However, since other conditions at birth can influence iron storage, the AAP is recommending iron supplementation to begin at 4 months of age.

The following chart summarizes the AAP’s new iron recommendations:

Age Daily Iron Requirements Iron Supplement Recommendations
Fed Human Milk Fed Formula Fed Cow’s Milk
Premature Infant (Less than 37 weeks gestation) 2-4 mg/dL 2 mg/kg per day No Standard Recommendation Should not be fed cow’s milk until 1 year of age
Beginning at 1 month of age until 12 months of age or until weaned to iron-fortified infant formula or iron-rich complimentary foods that supply 2 mg/kg of iron. Supplement may be started on an individual basis as determined by healthcare provider
Term Infant Less than 12 month of age Less than 6 months of age require 0.27 mg/dL 1 mg/kg per day None Should not be fed cow’s milk until 1 year of age
Beginning at 4 months of age and continued until iron-containing foods are introduced. Formula is fortified with iron (12 mg/L). May need supplementation if not consuming iron-rich complimentary foods at 6 months of age.
Between 7-12 months require 11mg/dL
Infants partially fed human milk (those whom consume at least half of their intake from human milk) should also receive this amount of iron supplementation until iron-containing foods are introduced.
Toddlers 1-3 years of age 7 mg/dL

7 mg/kg per day

Ideally from iron-rich food sources.


Iron-Rich Foods

Lean meats (beef, poultry and fish), cooked dried beans (lentils, pintos, kidney, etc), dark green leafy vegetables (spinach, collard greens, kale, etc), whole-grains and iron-fortified cereals and breads are excellent sources of iron. Want to know which foods contain the most amount of iron? Check out the USDA’sNational Nutrient Database: IronandDietary Guidelines for Americans 2005: Appendix B-3(2010 Guidelines in development) to see how much iron each food contains.

Iron is best absorbed when given with foods/juices high in vitamin C. Pair iron-rich foods and/or iron supplements with citrus fruits, berries, broccoli, vitamin c fortified juices, cantaloupe, bell pepper, tomatoes or greens for maximum iron absorption. Refer to the USDA’sDietary Guidelines for Americans 2005: Appendix B-9for foods containing the highest amount of Vitamin C. Foods that inhibit iron absorption include calcium (as in cow’s milk), phytates (found in soy, wheat bran, legumes. rice), and polyphenols (found in tea).

Maintaining an iron balance is key. Both deficiency and overload of iron should be avoided. As with any medication, iron supplements (liquid or pill form) should be kept out of the reach of children. Iron toxicity and death can occur in youngsters whom have ingested an overdose of iron supplements. Be sure to notify the Poison Control Center, your child’s physician or visit an emergency room immediately if excessive amounts of iron have been ingested.

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American Academy of Pediatrics News release:AAP Offers Guidance to Boost Iron Levels in Children. Oct 5, 2010.
Baker, R and Greer, F.Clinical Report Diagnosis and Prevention of Iron Deficiency and Iron-Deficiency Anemia in Infants and Young Children (0-3 Years of Age).Pediatricspublished online Oct 5, 2010.
Hallberg, L et al.The Role of Vitamin C in Iron Absorption.International Journal for Vitamin and Nutrition Research Suppl.(1989) 30:103-8.
National Anemia Action Council.Anemia and Nutrition: The Importance of Iron. Published July 16, 2008





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