Breastfeeding and Iron

I am starting my six-month-old on solids and am continuing to breastfeed. My child has been both breastfed and supplemented with milk-based formula (due to low milk production). I want to stop the formula and add solids and continue with the breastmilk I can produce. I don’t want to give her the processed baby cereal but I’m worried about iron. I’ve been told that due to their high iron needs babies, should be given fortified cereals until the age of two in order to avoid anemia. Since their iron needs are so incredibly high, can I ensure she gets enough iron without this fortified food? Can I safely focus on fruits and veggies and make my own baby cereals when the time comes? How can I avoid iron deficiency?

Babies aren’t designed to become anemic but many factors can lead to it. Iron deficiency anemia occurs in about 15 percent of babies, usually in the latter part of their first year. Premature birth and chronic bleeding from reactions to cow’s milk proteins in formula or nursing mother’s diet are a couple reasons a baby may become anemic. The common immediate clamping of the umbilical cord robs babies of a portion of the iron-rich blood intended for them and causes more anemia than there should normally be. Breastfed babies are more vulnerable to anemia when they’ve been receiving formula supplements or early solid foods as the free iron in these foods binds with the mom’s iron-protecting lactoferrin, decreasing the availability of mother’s iron to baby. Children switched to several servings of cow’s milk at one year may develop anemia after a few months on this diet.

It’s difficult to absorb iron from formulas, but most have very high iron levels in order to compensate for this. There are currently motions to reduce the iron in US infant formulas as the understanding is growing on the known negative effects of this high iron.

If you focus chiefly on vegetables and legumes, along with your breastmilk, your daughter will receive plenty of iron for normal day-to-day living and growing, but her past diet is something to consider in terms of vulnerability to anemia. Her mixed diet may not have had enough formula for her to receive enough of its high iron fortification, while the formula would have reduced the iron availability from your milk. She may have been tapping her iron stores. It’s not any problem as she’s likely too young for anemia to have manifested itself already, and it’s such an easy thing to test for, and to correct if needed.

Anemia in a baby can interfere with neurological development and immunity. There are also definite problems from iron supplementation that is not needed, including the amount in a serving of iron-fortified cereal. This iron fortification level is much higher than any natural food source other than liver. I personally would not feed much fortified cereal without cause. A fraction of a serving a day might not be a bad idea for the first few months on solids, but certainly not a full serving daily until age two without good reason.

One generally cannot detect anemia from symptoms alone until it’s quite advanced. I believe that if a child has risk factors, if parents are concerned about anemia, or feel eager to provide fortified cereal, they should just have baby tested. Many mothers prefer Floradix as a more natural source of iron supplementation when needed.