Are Iron Supplements Necessary for Breastfed Babies?

by Christine Albury

Many parents are led to to believe that routine iron supplementation is required for breastfed babies once they reach 6 months of age. Some studies, however, suggest that iron supplementation is unnecessary, unless signs of iron-deficiency anemia are present.

Iron plays an important role in the development of a baby's brain and a lack of iron can significantly affect a baby's ability to learn in later life. Iron is also required by the body to make hemoglobin, which supplies oxygen -- through the blood -- to the cells of the body. In addition, iron gives red blood cells their color, which is why a lack of iron is often suspected when someone appears particularly pale.

Babies are born with stores of iron, obtained from their mothers during pregnancy. For full term babies, these stores will usually last for at least the first 6 months of life. Some babies, however, are born with inadequate iron stores and have an increased risk of developing iron-deficiency anemia. These include:

  1. Premature babies. Babies obtain the majority of their iron stores from their mothers during the final months of pregnancy. This means that babies born prematurely may be more likely to have lower stores of iron at birth.
  2. Low birth weight babies (generally below 6.5lb). This applies whether or not the pregnancy was full term.
  3. Babies born to mothers with poorly controlled diabetes.

At some point, these babies may require iron supplementation, on medical advice.

However, it is the routine supplementation of full term, healthy, breastfed infants at 6 months that many experts are calling into question.

Whilst you may hear that the iron levels in breast milk are low, a fact very often overlooked is that iron from breast milk is extremely well absorbed, at a rate of 49 percent of the available iron. This is because breast milk contains lactoferrin and transferrin, two specialized proteins that ensure efficient delivery of iron from the milk to your baby. These proteins also prevent the growth of "unfriendly" bacteria, such as E. Coli, by ensuring that no iron is made available to them.

In addition, breast milk contains high levels of vitamin C and lactose, both of which assist with efficient iron absorption.

For these reasons, many experts now feel that an exclusively breast fed baby receives sufficient iron to keep his levels within the normal range BEYOND the first six months of life. It is, of course, a sensible precaution to have your baby's iron levels tested, to ensure that no deficiency is present.

Once iron supplements, solid foods or mixed feeding (ie breast milk plus iron-fortified formula) are introduced to a baby, the amount of iron available to him from breast milk actually reduces. This is because the specialized breast milk proteins can become saturated by the extra iron he is receiving. They then become less efficient in their job of delivering iron to the baby.

Therefore, it is very important to make sure that, when your baby is eating solid foods on a regular basis, his diet contains plenty of iron rich foods.

These will compensate for the reduction in the amount of iron he is receiving from breast milk. Good sources of iron include:

• meat
• peas
• dark green vegetables
• beans
• tofu
• avocado
• yam
• barley
• whole wheat cereal
• broccoli
• blackstrap molasses
• amaranth
• quinoa
• millet

It is useful to serve foods containing vitamin C along with iron rich foods, as this combination aids iron absorption. Cooking in cast iron pans is also helpful, as the acids in some foods will "pull" the iron from the pan.

It is important to remember that a nursing mother cannot increase the iron levels in her breast milk by increasing her own iron intake.

Christine Albury is the editor of www.homemade-baby-food-recipes.com, a complete guide to solid feeding during baby's first year.

Copyright © Christine Albury. Permission to republish granted to Pregnancy.org, LLC.