Breast-fed babies usually don't need to be given extra iron


January 14, 1992|By Dr. Modena Wilson and Dr. Alain Joffe

Q: Should breast-fed babies be on iron supplements since formula has iron in it?

A: Iron supplementation is not usually recommended for a breast- fed baby born at term and without complications. Human milk contains iron. Measure for measure it does not contain as much iron as formula, but the iron in human milk is more readily absorbed. When additional foods are added to the breast-fed baby's diet, however, the new foods may interfere with the absorption of iron from human milk. Therefore, it is important that those additional foods be rich in iron.

We usually recommend infant cereals as the first food because they are "iron-fortified." Cow's milk should not be fed to young babies. Not only is it a poor source of iron, but it can cause invisible bleeding from the intestine in some babies, resulting in iron loss.

If a breast-fed baby is getting occasional formula supplementation, it certainly should be formula with iron. Babies who are exclusively breast-fed will outgrow their iron supply by about 6 months of age and will need additional iron from iron drops or from iron-rich food.

Although most young breast-fed babies do not need supplemental iron, they do need vitamin D for bone growth. Your doctor may also recommend fluoride to help developing teeth resist cavities. But with those two exceptions, human milk is all most young infants need. After all, Mother Nature knew what she was doing.

Dr. Wilson is director of general pediatrics at the Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.

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