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AAP: Infants Should Be Screened for Iron Deficiency at 12 Months
According to a new statement from the American Academy of Pediatrics (AAP), babies should have their iron levels tested at 12 months to screen for iron deficiency and iron deficiency anemia. Too little iron in the body can cause long-term neurodevelopmental problems, even after it is treated. Iron deficiency remains the number one nutrient deficiency in the world.
"There is growing evidence that iron deficiency and iron deficiency anemia have long-term effects on behavioral and neurodevelopmental issues that can appear one to two decades after the anemia is treated’, says one of the study’s authors, Robert D. Baker Jr. Some of these effects can be irreversible.
Iron deficiency can be dangerous because if the body’s reserves are low, the brain becomes deprived of iron so that it can be routed to the blood. Iron deficiency without anemia is still critical because it by itself can lead to lasting developmental problems. Co author Frank Greer says, "[b]y the time you develop anemia, you’ve been iron deficient for a while".
In 1999, the AAP released a recommendation regarding the iron fortification of infant formula. Now, they urge parents to give iron supplements to their breastfed babies starting at 4 months old. They suggest this age since babies get enough iron in utero to last them for the first four months of life. After this, the authors say, it’s crucial to supplement since breast milk does not contain adequate amounts of iron.
How much iron do babies and toddlers need? According to the paper, "it is recommended that exclusively breastfed term infants receive an iron supplementation of 1 mg/kg per day, starting at 4 months of age and continued until appropriate iron-containing complementary foods have been introduced". In other words, breastfed babies should receive 1 mg/kg of body weight starting at four months. From six to 12 months, breastfed babies should get 11 mg/day, no matter how much they weigh, and toddlers should get 7 mg/day until they are three.
The authors of the report also point out that as an infant is beginning to eat solid foods, red meat is typically introduced to an infant last (cereals, veggies, and fruits are usually offered sooner). But given the new guidelines, it may make sense to introduce red meat to babies earlier.
Vegetarian families should pay particular attention to their children’s iron intake; some cereals, vegetables, and beans provide iron, but it may still be necessary to supplement further. Greer points out that "[y]ou have to eat a lot of black beans to get the equivalent of a serving of red meat."
For more information, see the AAP’s report http://pediatrics.aappublications.org/cgi/reprint/peds.2010-2576v1.pdf, published online October 5, 2010 in the journal Pediatrics.
October 30, 2010
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