Understanding the AAP’s New Iron Intake Guidelines

October 15th, 2010 by Colleen Hurley, RD, Certified Kid’s Nutrition Specialist

The American Academy of Pediatrics (AAP) new iron intake guidelines may have left a lot of parents scratching their heads in confusion.  Iron is indeed a vital nutrient for healthy baby development; and although iron deficiency has decreased significantly over the past several decades the AAP’s new guideline is meant to decrease rates even rates even further.

The Stats

In the early 1970’s, iron began being added to infant formulas, cereals, and other foods.  This fortification nearly diminished iron deficiency and subsequent iron deficiency anemia.  In the US, iron deficiency currently affects about 4% of 6 month olds, 12% of 12 month olds, and between 6.5- 15% of toddlers aged 1-3 years.  Rates vary depending on race and socioeconomic status; and preterm infants along with exclusively breastfed babies are at higher risk.

Iron Functions

The body needs iron to make hemoglobin, which is responsible for carrying oxygen through the blood to the cells in the body.  It is also responsible for the bright, red color of red blood cells so when the cells become pale and small from insufficient iron intake, the result is iron deficiency anemia.  Babies, in particular, need iron for healthy brain development and a deficiency can result in learning difficulties later in life.

Breastfeeding

So, should this change your thoughts on breastfeeding? No, absolutely not! Breastfeeding is one of the greatest gifts you can give your baby, and yourself as the health benefits for both mom and baby are overwhelming.  A healthy, full term baby has enough iron stores for about 4-6 months and the amount of iron stores is directly related to a mother’s iron intake during pregnancy. Conversely, however, a mother’s intake of iron during breastfeeding will not increase her baby’s iron stores.  Adding an iron supplement for breastfed babies is a highly debated subject amongst the breastfeeding community because having too much iron can be equally as dangerous as having too little and the amount of breastfed babies that  are iron deficient is actually very small.  Comparatively, the absorption rate of iron in breast milk is about 49%, about 7% from infant formula, and 4% from iron fortified cereals.  The key is to talk to your doctor and have your baby’s hemoglobin checked before you start supplementing.

Supplementation

The same goes for breastfed or formula fed babies – talk to your healthcare provider before you give your child a supplement.  The AAP explains that babies on an iron fortified infant formula do not need a supplement, and that at 6 months all babies can be started on an iron fortified infant cereal.  The table below indicates iron needs during the lifecycles in the US and Canada:

RECOMMENDED DAILY IRON INTAKE (RDI) CANADA (RNI)    
Infants 6-12 months 11mg*  
Toddlers, 1-3 years 7mg* .3-6mg
Children, 3-10 years 10 mg 8-10
Teen males 12 mg 8-10mg
Adults males 10 mg 8-10mg
Teen and adult females 18 mg 8-13mg
Pregnant women 30 mg 17-22mg
Nursing females 15mg 8-13
 *Part of the AAP New Guidelines  

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