Iron is an essential mineral that supports healthy brain development, growth, and the production of red blood cells in infants. Because babies grow rapidly in the first year of life, their iron needs may be high. Yet, each child is different, and no one set recommendation works for all infants. Advice from health care professionals will vary. Let’s explore what we know about iron supplementation in infants, what current recommendations are, and what parents should know.
Why is iron so important in infancy?
Iron plays a critical role in early brain development. Iron deficiency in infancy has been associated with long-lasting effects on development. Iron deficiency is one of the most common nutritional deficiencies in children worldwide.
Full-term infants are typically born with iron stores they get from their mother’s placenta. These last for about the first four months of life. After that, sources of iron start to get low and supplementation may become essential. Preterm infants are at even higher risk of iron deficiency because they miss part of the third trimester, when most of the transfer of iron from the placenta occurs.
What do we know about iron supplementation recommendations?
Preterm and low birth-weight infants often require higher amounts of iron earlier in their life, , because of lower iron stores at birth. Other reasons for early iron supplementation include if the mother had low iron levels, high blood pressure or diabetes during pregnancy and issues with the placenta’s ability to function. All of these things could mean the baby received less iron while they were inside their mother.
Full-term babies that are exclusively breastfed are recommended to receive 1 mg/kg per day of oral iron supplementation starting at 4 months of age. This is usually something they can stop once they are able to eat iron-containing foods (for example, cereals and other foods fortified with iron, meats, certain beans and leafy green vegetables). Formula-fed infants generally receive adequate iron from iron-fortified formula and typically do not require additional supplementation.
Universal screening for anemia or low red blood cell counts is recommended at around 12 months of age. Iron deficiency is a common reason for low red blood cell counts, which is why going to routine well child visits is important – particularly in the first year of life. Importantly, iron deficiency cannot be diagnosed or treated on symptoms alone. Laboratory evaluation is needed to confirm low iron or red blood cell levels and to guide appropriate dosing.
What are the concerns or risks with iron supplementation?
When used at recommended doses, iron supplementation is safe. However, possible side effects include constipation, dark stools, nausea, or abdominal discomfort. Giving more than the recommended dose can be harmful. Iron overdose can occur and is a medical emergency that needs treatment.
What are we still learning?
We know preventing iron deficiency is critical for healthy development in babies. Research continues to work on identifying iron deficiency and dosing strategies for different babies. We are also still doing research on how long-term neurodevelopmental outcomes are affected by low iron levels in babies.
Iron supplementation, when recommended by a healthcare professional and given at appropriate doses, is a safe and effective way to prevent low iron levels or deficiency in infants. If you have questions about your baby’s iron needs, talk with your pediatrician.
References
https://www.chop.edu/conditions-diseases/iron-deficiency-anemia-in-children
Iron is an essential mineral that supports healthy brain development, growth, and the production of red blood cells in infants. Because babies grow rapidly in the first year of life, their iron needs may be high. Yet, each child is different, and no one set recommendation works for all infants. Advice from health care professionals will vary. Let’s explore what we know about iron supplementation in infants, what current recommendations are, and what parents should know.
Why is iron so important in infancy?
Iron plays a critical role in early brain development. Iron deficiency in infancy has been associated with long-lasting effects on development. Iron deficiency is one of the most common nutritional deficiencies in children worldwide.
Full-term infants are typically born with iron stores they get from their mother’s placenta. These last for about the first four months of life. After that, sources of iron start to get low and supplementation may become essential. Preterm infants are at even higher risk of iron deficiency because they miss part of the third trimester, when most of the transfer of iron from the placenta occurs.
What do we know about iron supplementation recommendations?
Preterm and low birth-weight infants often require higher amounts of iron earlier in their life, , because of lower iron stores at birth. Other reasons for early iron supplementation include if the mother had low iron levels, high blood pressure or diabetes during pregnancy and issues with the placenta’s ability to function. All of these things could mean the baby received less iron while they were inside their mother.
Full-term babies that are exclusively breastfed are recommended to receive 1 mg/kg per day of oral iron supplementation starting at 4 months of age. This is usually something they can stop once they are able to eat iron-containing foods (for example, cereals and other foods fortified with iron, meats, certain beans and leafy green vegetables). Formula-fed infants generally receive adequate iron from iron-fortified formula and typically do not require additional supplementation.
Universal screening for anemia or low red blood cell counts is recommended at around 12 months of age. Iron deficiency is a common reason for low red blood cell counts, which is why going to routine well child visits is important – particularly in the first year of life. Importantly, iron deficiency cannot be diagnosed or treated on symptoms alone. Laboratory evaluation is needed to confirm low iron or red blood cell levels and to guide appropriate dosing.
What are the concerns or risks with iron supplementation?
When used at recommended doses, iron supplementation is safe. However, possible side effects include constipation, dark stools, nausea, or abdominal discomfort. Giving more than the recommended dose can be harmful. Iron overdose can occur and is a medical emergency that needs treatment.
What are we still learning?
We know preventing iron deficiency is critical for healthy development in babies. Research continues to work on identifying iron deficiency and dosing strategies for different babies. We are also still doing research on how long-term neurodevelopmental outcomes are affected by low iron levels in babies.
Iron supplementation, when recommended by a healthcare professional and given at appropriate doses, is a safe and effective way to prevent low iron levels or deficiency in infants. If you have questions about your baby’s iron needs, talk with your pediatrician.
References
https://www.chop.edu/conditions-diseases/iron-deficiency-anemia-in-children
Fact chat for your child's health and wellness
Interested in more factual information on medical myths and rumors? See the trending topics that are coming from our Pediatric Health Chat project.