Sue Hubbard, M.D.

An article published in the journal Pediatrics from the American Academy of Pediatrics committee on nutrition sets new guidelines for iron intake in infants and children. The news is not good.

According to Dr. Frank Greer, co-author of the report, "iron deficiency remains common in the United States." The effects of being iron deficient not only trigger anemia, but may also cause "long-term irreversible effects on children's cognitive and behavioral development. Because of these findings, it's imperative that adequate iron is provided in infancy and early childhood.

Studies have shown that 4 percent of 6-month-old children, and 12 percent of 12-month-olds are iron deficient. Children from 1 to 3 years old have rates of iron deficiency between 6-15 percent. Pre-term infants, infants exclusively breast-fed and those at risk for developmental disabilities seem to be at higher risk to develop iron deficiency.

The committee recognized that the ideal way to prevent iron deficiency and iron deficiency anemia would be with a diet consisting of foods that are naturally rich in iron, but realized that in some cases "children will still need liquid iron supplements or chewable vitamins to get the iron they need."

The AAP guidelines now recommend that:

1. Term healthy babies that are exclusively breast-fed should receive an iron supplement (1 mg per day) beginning at 4 months old.

2. Whole milk should not be started until a child is 12 months old.

3. Infants 6-12 month's old need 11 mg of iron per day, which should be met via the use of "complementary" foods. Red meat and vegetables with high iron content should be introduced early, as well as iron-fortified cereals.

4. Toddlers ages 1-3 years need 7 mg of iron per day, and again it's best if iron comes from foods.

5. Children should have their hemoglobin checked sometime between 9-12 months old, and again between 15-18 months old, and follow-up for iron deficiency treatment and testing is recommended.

6. Children who don't meet their iron needs via foods should receive a daily iron supplement.

The article contains a table showing many foods that are good sources of iron. Foods like meat, shellfish, beans, iron fortified cereals, and fruits and vegetables that contain vitamin C (which aids in iron absorption) are all encouraged.

Thanks to my mother, I've always known liver is a good source of iron (never my favorite dinner as a child), but who would have known that clams and oysters are also high in iron? While oatmeal is a good iron source, so is molasses. Tofu and wheat germ are also high in iron, as are edema me beans, which many kids love.

By getting creative with foods that are high in iron beginning early in a child's life, iron deficiency may be avoided. And remember, you never know what your child will eat unless you try it!

Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show.


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Health - Iron Deficiency Can Have Serious Consequences