Iron is a very important mineral in infants' and children's diet. Without sufficient iron in their diet, children's motor, mental and behavioral development can be hampered. Unfortunately, these developmental delays are not always correctable even when the proper dosage of iron is later added to the diet. A study following infants diagnosed with iron deficiency found that at 11-14 years of age many of these children still demonstrated functional deficiencies in school.
Despite numerous studies documenting the importance of iron, many infants and toddlers do not get the iron they need. A recent study in Pediatrics magazine found that 58% of breastfed and mixed-fed infants (infants fed a combination of formula and breast milk) did not get the recommended amount of iron a day.
Early in infancy breast milk is a sufficient source of iron. Although breast milk is not high in iron, the iron is very well absorbed. From birth to 6 months of age, a full-term infant's daily iron requirement is only 0.27mg/day. This jumps to around 11mg/day by 6 months of age. Preterm infants have a higher iron requirement and should usually be started on 2mg/kg/day of iron supplementation around 1-2 months of age, although parents of a preterm infant should talk with their pediatrician before starting any vitamins as the iron requirement can vary with birth weight.
Most formulas are now iron fortified. Infants taking solely formula receive a sufficient amount of iron through the formula. However for breastfed and mixed fed infants, an additional source of iron supplementation should be introduced between 4-6 months of age. This can be in the form of vitamins such as Tri-Vi-Sol with iron, which has the added benefit of fulfilling both the infant's vitamin D and iron requirement, or through iron-rich foods.
By 6 months of age, most infants are transitioning to solid foods. By choosing iron-rich foods as a baby's first transitioning food you can ensure that your infant receives the proper amount of iron through his diet. In the US it is common for an infant's first food to be iron-fortified cereal. Most fortified cereals have about 45% of the recommended iron per serving, which is usually 4 tablespoons. Therefore, an infant would have to eat 8 tablespoons of iron-fortified cereal a day in order to fulfill his iron requirement from cereal alone.
Red meat is another iron-rich food. In other countries, it is very common for pureed meat to be one of the first foods an infant eats. As odd as this might sound here in the US, where meat is typically one of the latter foods to be introduced, even The American Academy of Pediatrics endorses its early introduction at around 6 months of age.
By 6 months of age, a breastfed or mixed-fed infant must consume at least two servings of iron-rich foods a day in order to ensure that he is getting 11mg of iron from his diet. If less than two servings of iron-rich foods are being consumed on a regular basis then iron-containing vitamins should be started.
Iron continues to be important in the toddler's diet. At one year of age, infants transition from formula to whole milk. Whole milk is low in iron and its calcium inhibits iron absorption. For this reason, it is recommended that toddlers do not consume more than 16-24 ounces of milk a day. Toddlers who are notoriously picky eaters still require one to two servings of iron-rich foods a day. If their picky eating habits make this difficult, then they should continue taking a vitamin containing iron.