There’s so much to remember when raising a child, it’s easy to let a key nutrient slip through the cracks. While you carefully plot your infant’s diet, don’t forget to include iron. Iron is the most commonly deficient nutrient in both undeveloped and developed nations, including the U.S. Babies are especially at risk for not getting enough iron, but thankfully the American Academy of Pediatrics recently issued new guidelines regarding iron in infants and toddlers aged 1 to 3 years.
According to the new guidelines, healthy, breastfed full-term infants should be supplemented with 1 mg of iron per 2.2 lbs of body weight beginning at age 4 months until the baby is fed iron-fortified foods such as cereals. Although extra iron is stored in the fetus in the third trimester of pregnancy, exclusively breastfed infants may develop iron deficiency because human milk is very low in iron, especially if the mother herself is iron-deficient.
More than 9 percent of U.S. toddlers have iron deficiency and more than 2 percent had iron deficiency anemia. Iron-deficiency anemia, characterized by an insufficient number of healthy, oxygen-carrying red blood cells caused by inadequate stores of iron, and iron deficiency without anemia are serious concerns. These conditions can lead to long-term and often irreversible neuro-developmental and behavioral defects in developing children. The report details guidelines for iron requirements, diagnosis and prevention of iron deficiencies in infants and toddlers.
Infants fed standard formula through age 12 months receive adequate iron intakes, as long as iron-fortified cereals or other complementary foods are added to the diet between ages 4 and 6 months. Between the ages of 6 and 12 months, iron needs increase to 11 mg per 2.2 lbs. of body weight daily. The diet, beyond human milk or formula, should therefore include iron-rich complementary foods, and a liquid supplement can be given if formula and foods are not meeting these needs.
Things are a little different for toddler and preterm infants; preemies need a minimum of 2 mg of iron per kilogram (2.2 lbs) of body weight daily for the first year, either from formula fortified with iron or human milk and a daily iron supplement of 2 mg iron per kilogram of body weight daily. Between the ages of 1 and 3 years, iron needs go down slightly to 7 mg of iron per 2.2 lbs of body weight.
Parents should always consult a pediatrician before giving an infant or child iron supplements and are further advised to keep all iron-containing supplements away from children, as an accidental overdose of iron can be toxic to children. Experts also stress the importance of not feeding an infant liquid cow’s milk before 12 months of age, in part because it is iron-poor and tends to displace essential iron-rich foods from the diet.
Experts further recommend that all babies be screened for anemia starting at age 12 months. The report highlights the need to assess risk factors for iron deficiencies, such as low birth weight, preterm birth, exclusive breastfeeding, and the feeding of cow’s milk before 12 months of age.