Does my baby need iron added to his diet? We have had some off-handed recommendations at doctor visits that maybe we might start to think about possibly giving him iron drops, you know, if we want. I began doing some research (see sources below) and I read that at six months babies do not get as much iron from breast milk as they need (more on that later). So we started solid foods at six months with iron-fortified rice cereal. Then I read the label, and despite the fact that my baby is sort of gigantic (as in 98th percentile), he only eats about 1 tablespoon of solid foods a day, and it isn't always rice cereal. He still prefers leche de madre. And the label says one serving has 45% of the daily recommended amount of iron, and one serving is 4 tablespoons! I read that the iron babies get from breast milk is better absorbed into their system than the iron they get from fortified cereals or formula (1), but still it might not be enough. So we went shoppin' for some iron drop supplements.
At CVS drugstore and at Target pharmacy, they only have Enfamil Vi-sol iron drops for infants. Being cautious parents, we made the mistake of reading the label which has an awful lot of crap like caramel color and artificial flavors. Not stuff I want to feed my infant. So I went to New Pi Coop to find out that a few of the ladies in the Wellness department have been working on finding a solution to this very problem. But they have not yet found decent natural iron drops. One book is all about homemade (non-fortified) foods, so they recommend an over the counter iron supplement, but then they warn that some brands can stain teeth and too much is not healthy and can cause constipation (1).
Why add iron to a baby's diet? Iron deficiency during the first 18 months of life causes health and behavioral problems (1) . Iron deficiency is common in North America. The symptoms include being tired, irritable, loss of ability to concentrate and behavior/development problems (2). Low iron causes the baby to be pale, irritable, tired and have a decreased appetite (3). Between 6 months to 3 years, children need substantial amounts of iron to fuel their rapid growth. The danger period is most acute between 12-18 months when children are transitioning from iron-fortified foods to solids and switching to cows milk, which can displace iron-rich foods and reduce the iron absorption. (3)
One book says breast milk is sufficient for 4-6 months, or until the baby's weight doubles (1) (which was at three months for my little growth spurt). Another book says iron needs are met by breast milk in the first six months of life. (2) I believe the latter, because of some charts I came across. Two sources said infants 0-6 months only need .27 mg/day. 7-12 month olds need 11 mg/day (2) (3) (quite a jump!) A 3rd book was a bit different saying that 0-6 month olds require 6 mg of iron per day. (4) After 6 months, they get iron from fortified formula or cereal. (4)
So baby papa and I discussed what people have been doing for thousands of years. And I said they were feeding their babies meat and the food the adults were eating, using their medieval immersion blenders to puree the food. It seems one book leans toward the vegetarian baby (1), so it hasn't really recommended that we feed our baby meat yet, but I suppose that would help. The idea of feeding our baby food that we eat is a great one, and something our parents did for us. but here is the main problem: we don't eat very bland food. In fact, we like to spice it up. A lot. And you don't really add the spices after cooking the food, so that some of it can be set aside for the kid. You add them at the beginning of the meal so that the food has time to cook and absorb the flavor of each spice. Possibly not good for a baby tasting foods for the first time.
Rice and millet are sources of iron from plants, but they are "not as well assimilated as iron from meat" (1). The animal source of iron is called heme, which is better absorbed by the body. The heme iron is absorbed 2-3 times better than non-heme. Iron fortified cereal has 7 mg of iron in a 1/2 cup and iron fortified formula has 5 mg per cup (2). Good sources of heme iron include beef, chicken and halibut.(2)
I didn't come across how much iron breast milk has, maybe that has to do with how much iron the mother is consuming. A breast feeding woman should get 9 mg of iron a day (3). Does it make a difference that I take a multi-vitamin every day? I have also heard (but not read) that the iron from breast milk is better absorbed by the baby. I guess that's because being an animal, I am providing "heme" iron.
The non-animal iron source is called non-heme (2) Non-heme sources are cereal, spinach, potatoes, beans, enriched rice, prune juice, whole wheat bread, navy beans, raisins, & avocado.
Homemade cereals do not have enough iron, so you should mix them with the commercial iron fortified cereal for adequate iron intake, or use an iron supplement (3). Why would you go to all the trouble of making homemade rice cereal if you are going to add commercial rice powder to it? Good sources of iron (over 1 mg per serving) include liver (by far the best at 9 mg!- I did not come across what age babies can eat liver), tofu, spinach, peas, dark greens. (3) .2-.9mg foods include potatoes with skin, broccoli, bread, strained infant meat (that sounds illegal!) chicken, halibut, enriched rice, apricots. (2)
You can increase the amount of iron the body absorbs by combining it with vitamin C. (1) (2)
Wow, once again, I've gotten really long-winded here, and with not much to report except for the frustration that I feel it's important to get more iron to my infant and I'm not sure how to do it in a way that I feel is REALLY great for him. And apparently it's important for babies up to 18 months old to get enough iron in order to not have behavioral disabilities when they get older. Or is that just another one of those studies that they've come up with which will be superseded by a new study in a few years?
1. Super Baby Food by Ruth Yaron
2. Blender Baby Food by Nicole Young
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