Iron and Baby, How much Iron does Baby Need? Is there Iron in Homemade Baby Food? Iron Supplement in Baby Food

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Iron and Your Baby - It really isn't a great concern for most infants.

Could my baby be at risk for Iron deficient anemia?

Babies who may be at risk fall into the following categories:

Babies that were born premature (iron stores build in the last few months of pregnancy)
Babies who had a low birth weight regardless of being "full term"
Infants whose mothers were of poor nutritional status during pregnancy or who have diabetes

So how long do a baby's Iron stores last? What about the Breast-Fed Baby?

For both formula fed and breastfed healthy full-term infants, iron stores are well maintained up until the 6-7 month age mark when the iron stores may then begin to deplete. Babies who are formula fed are seldom at risk for iron deficiencies due to the high amount of iron in iron-fortified formulas. Infants who are exclusively breastfed are also seldom at risk for iron deficient anemia especially if the baby does not begin solid foods earlier than 6 months old.

Introducing solids too early to baby may actually hinder the iron levels in the baby; most often this is related to breastfed babies. If a baby is exclusively breastfed, then baby is getting all the iron needed up to about the 6–9 month mark.

“Most breastfeeding babies do not need any water, vitamins, or iron in addition to breast milk for at least the first 6 months. Human milk provides all the fluids and nutrients a baby needs to be healthy. By about 6 months of age, however, you should start to introduce your infant to baby foods that contain iron. Your pediatrician may prescribe Vitamin D or Iron supplement if there is a need for it.” American Academy of Pediatrics. A Woman’s Guide to Breastfeeding” AAP Breastfeeding Guide

“Iron deficiency is rarely seen in breastfed babies during the first six months of life. Iron is present in your milk. Although human milk does not contain large amounts of iron, it is very well absorbed. Approximately 50 percent of the iron in mother's milk is absorbed, compared to only a 7 percent absorption from formula, and a 4 percent absorption from infant cereals (Dallman 1986). Since a full-term baby's iron stores begin to diminish around six months of age, solid foods can help to meet your baby's increased need for iron and protein at that time.” Debbi Donovan - Director of ParentsPlace.com and also a Board Certified Lactation Consultant. Parent's Place Lactation Consultant

Table added 07 July 2007

TABLE 2. Iron absorption by infants fed formula or milk (8)
Substance	Iron content (mg/L)	Bioavailable iron (%)	Absorbed iron (mg/L)
Nonfortified formula	1.5-4.8*	~10	0.15-0.48
Iron-fortified formula+	10.0-12.8*	~ 4	0.40-0.51
Whole cow's milk	0.5	~10	0.05
Breast milk	0.5	~50	0.25

* Values are given for commonly marketed infant formulas.
+ Iron-fortified formula contains >=1.0 mg iron/100 kcal formula (8). Most iron-fortified formulas contain approximately 680 kcal/L, which is equivalent to >=6.8 mg iron/L.
Taken from the CDC Recommendations to Prevent and Control Iron Deficiency in the United States
One nonrandomized study with a small cohort suggested that exclusive breast feeding for greater than 7 months is protective against iron deficiency compared with breast feeding plus the introduction of non-iron-fortified foods at age less than or equal to 7 months infants weaned to iron-fortified foods were not included in this study. Pisacane A, De Vizia B, Valiente A, et al. Iron status in breast-fed infants. J Pediatr 1995; 127(3):429-31.

"Iron in human breast milk is well absorbed by infants. It is estimated that infants can use greater than 50% of the iron in breast milk as compared to less than 12% of the iron in infant formula [1]. The amount of iron in cow's milk is low, and infants poorly absorb it. Feeding cow's milk to infants also may result in gastrointestinal bleeding. For these reasons, cow's milk should not be fed to infants until they are at least 1 year old [1].

The American Academy of Pediatrics (AAP) recommends that infants be exclusively breast fed for the first six months of life. Gradual introduction of iron-enriched solid foods should complement breast milk from 7 to 12 months of age [26]. Infants weaned from breast milk before 12 months of age should receive iron-fortified infant formula [26]. Infant formulas that contain from 4 to 12 milligrams of iron per liter are considered iron-fortified [27]." National Institutes of Health - Office of Dietary Supplements

If I do not offer Iron fortified commercial infant cereals, will my baby become iron deficient?

You will not be able to “fortify” homemade baby cereals the way commercial cereals are fortified. Other than commercial baby cereal, jarred baby food is not fortified with iron. There are many things you may add to the cereals that will give an “iron boost” such as formula, breast milk, wheat germ, and brewer's yeast to name a few. Once you have introduced fruits and veggies along with the cereals, you will get Vitamin C which helps to aid in the absorption of iron.

Commercial baby cereals are highly processed and nutrients, including any hint of iron, are stripped in the processing and then added back in. The iron that is found in commercial baby cereals is not as easily absorbed as that which is natural in foods.

Iron is found in food in two forms, heme and non-heme iron.

Heme iron, which makes up 40 percent of the iron in meat, poultry (incl. eggs, in particular the yolks), breast milk and fish is well absorbed.

Non-heme iron, 60 percent of the iron in animal tissue and all the iron in plants (fruits, vegetables, grains, nuts) is less well absorbed. The Vegan Resource Group

What types of Foods are Iron Rich and Will Help My Baby Get Enough Iron?

We have outlined foods that are rich in iron below. Try to serve your infant at least 2 of these foods (ensure that the foods are age appropriate) once baby begins to decrease breast milk/formula intake and begins more "meals"

FOODS THAT ARE IRON RICH

breast milk & iron-fortified infant formula
dried beans
winter squash
sweet potatoes
broccoli
mushrooms
meat & poultry (beef, beef & chicken liver, pork, turkey, chicken)
greens (spinach, broccoli, beet, tomato )
egg yolks
dried fruit (figs, apricots, prunes, raisins)
prune juice
tofu
grains (cooked cracked wheat, wheat germ, cornmeal, millet, brown rice, farina, bran, breads, iron fortified cereals)
blackstrap molasses (try adding a little to cereal when baby is over 10 months old)
brewer's yeast
shellfish (clams, oysters, shrimp)
tuna, sardines, canned salmon

Vitamin C aids in the absorption of Iron. Try to have baby eat or drink it whenever possible.

How Much Iron is in the Food I Feed my Baby? See How Much Iron is in 1 Tablespoon of the following common baby foods:
(there is approximately 14.23 grams in 1 tablespoon) Compiled from the UDSA Nutrient Database

Broccoli: .09 mg

Sweet Potato: .10mg

Beef: .36 mg

Chicken: .15 mg (light meat) .19 mg (dark meat)

Egg Yolk: .38 mg

What is the Recommended Daily Intake of Iron for Baby?

The RDA for iron was revised in 2001 and is based on the prevention of iron deficiency and maintenance of adequate iron stores in individuals eating a mixed diet (11).

Recommended Dietary Allowance (RDA) for Iron Iron Reference at Oregon State
Life Stage	Age	Males (mg/day)	Females (mg/day)
Infants	0-6 months	0.27 (AI)	0.27 (AI)
Infants	7-12 months	11	11
Children	1-3 years	7	7
Children	4-8 years	10	10
Children	9-13 years	8	8
Adolescents	14-18 years	11	15
Adults	19-50 years	8	18
Adults	51 years and older	8	8
Pregnancy	all ages	-	27
Breastfeeding	18 years and younger	-	10
Breastfeeding	19 years and older	-	9

Maximize Baby's Iron Absorption - Meals, Vitamin C and Iron

(Did you know Breast Milk contains Vitamin C? It certainly does.)

As your infant grows, you can increase the absorption of iron (non-heme) from "plant" foods as well as the (heme) iron from "protein/meat" foods when a food containing vitamin C is eaten at the same meal or snack. Serving cereals with a fruit that contains Vitamin C would aid in the absorption of the iron contained in the cereal product.

Eating foods that are high in Vitamin C will help the body absorb non-heme iron that is present in most foods served in a meal. The majority of iron that most people receive is non-heme iron; this type of iron has less bioavailability and is absorbed in smaller quantities by the body. Get that Vitamin C working to help fully utilize Iron.

Most pediatricians in the US will recommend that you serve a fruit and a veggie together with a cereal for a meal. As baby gets older, serving a fruit, protein (such as chicken), vegetable and yogurt is a perfectly balanced meal.

FOODS THAT ARE VITAMIN C RICH

Citrus fruits
Berries
Green vegetables (such as broccoli and cabbage)
Peaches
Apples
Bananas
Tomatoes
Fortified Apple (or other fruit) Juices with Vitamin C.

Read Giving Baby Juice to learn about Fruit Juice and Your Baby

Table 1: Selected Food Sources of Heme Iron [10]

Food (Note that 2 tablespoons equals 1 ounce (U.S.)	Milligrams per serving	% DV*
Chicken liver, cooked, 3½ ounces (7 tablespoons)	12.8	70
Oysters, breaded and fried, 6 pieces	4.5	25
Beef, chuck, lean only, braised, 3 ounces (6 tablespoons)	3.2	20
Clams, breaded, fried, ¾ cup	3.0	15
Beef, tenderloin, roasted, 3 ounces	3.0	15
Turkey, dark meat, roasted, 3½ ounces (7 tablespoons)	2.3	10
Beef, eye of round, roasted, 3 ounces	2.2	10
Turkey, light meat, roasted, 3½ ounces	1.6	8
Chicken, leg, meat only, roasted, 3½ ounces	1.3	6
Tuna, fresh bluefin, cooked, dry heat, 3 ounces	1.1	6
Chicken, breast, roasted, 3 ounces	1.1	6
Halibut, cooked, dry heat, 3 ounces	0.9	6
Crab, blue crab, cooked, moist heat, 3 ounces	0.8	4
Pork, loin, broiled, 3 ounces	0.8	4
Tuna, white, canned in water, 3 ounces	0.8	4
Shrimp, mixed species, cooked, moist heat, 4 large	0.7	4

Table 2: Selected Food Sources of Non-heme Iron [10]

Food (2 tablespoons equals 1 ounce and 8 ounces equals 1 cup (U.S.) )	Milligrams per serving	% DV*
Ready-to-eat cereal, 100% iron fortified, ¾ cup	18.0	100
Oatmeal, instant, fortified, prepared w/ water, 1 cup	10.0	60
Soybeans, mature, boiled, 1 cup	8.8	50
Lentils, boiled, 1 cup	6.6	35
Beans, kidney, mature, boiled, 1 cup	5.2	25
Beans, lima, large, mature, boiled, 1 cup	4.5	25
Beans, navy, mature, boiled, 1 cup	4.5	25
Ready-to-eat cereal, 25% iron fortified, ¾ cup	4.5	25
Beans, black, mature, boiled, 1 cup	3.6	20
Beans, pinto, mature, boiled, 1 cup	3.6	20
Molasses, blackstrap, 1 tablespoon	3.5	20
Tofu, raw, firm, ½ cup	3.4	20
Spinach, boiled, drained, ½ cup	3.2	20
Spinach, canned, drained solids ½ cup	2.5	10
Black-eyed peas (cowpeas), boiled, 1 cup	1.8	10
Spinach, frozen, chopped, boiled ½ cup	1.9	10
Grits, white, enriched, quick, prepared w/water, 1 cup	1.5	8
Raisins, seedless, packed, ½ cup	1.5	8
Whole wheat bread, 1 slice	0.9	6
White bread, enriched, 1 slice	0.9	6

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NOTE Resources For Iron Information

AlternativeMed.- Iron Facts

Iron in the Vegan Diet

Avoiding Iron Deficiency

Iron and Breastfeeding - NIH

KellyMom - Solids and Iron

KellyMom - Iron

AAP - Breastfeeding and Human Milk AAP- Infant Nutrition

Breastfeed.com - Iron Supplements

Iron Bio-Availability in Infants

Screening for Anemia in Infants

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Iron and your Baby - Iron in Food Your Baby Eats, Does Your Baby need More Iron?

Iron and Your Baby - It really isn't a great concern for most infants.

Could my baby be at risk for Iron deficient anemia?

So how long do a baby's Iron stores last? What about the Breast-Fed Baby?

What types of Foods are Iron Rich and Will Help My Baby Get Enough Iron?