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The Physicians Committee



Doctors Recommend Plant-Based Iron Sources for Infants

By Kathryn Strong, M.S., R.D.
Oct. 8, 2010

The American Academy of Pediatrics (AAP) released guidelines to help prevent and diagnose iron deficiency in children from birth to 3 years of age. These guidelines are aimed at increasing screening and follow-up practices among pediatricians, as well as increasing dietary and supplemental iron during this critical developmental stage.

Doctors and dietitians with the Physicians Committee for Responsible Medicine commend the AAP’s encouragement of better monitoring and follow up of an infant’s nutrient status. However, it’s important to note that consuming red meat is not ideal for children’s lifelong health goals. Meat is high in fat and saturated fat, contributors to chronic diseases, such as heart disease, type 2 diabetes, and some forms of cancer. Meat also contains cholesterol and is more likely to carry foodborne illnesses.

Plant-based sources of iron are more healthful and easily accessible. Because plant iron’s bioavailability is easily influenced by inhibitors (e.g., phytates and calcium) and enhancers (e.g., vitamin C and other organic acids found in fruits and vegetables), complementing plant-based iron sources with foods like oranges or carrots is recommended. Cow’s milk inhibits iron absorption, because it contains high levels of calcium and may exacerbate iron loss in infants sensitive to cow’s milk proteins.

The American Dietetic Association, the largest organization of nutrition professionals in the world, states in its position paper on vegetarian diets, “Well-planned vegetarian diets are appropriate for individuals during all stages of the lifecycle, including pregnancy, lactation, infancy, childhood, and adolescence.”

Preventing Iron Deficiency Anemia in Infancy and Early Childhood

Until at least 4 months of age, healthy full-term infants can meet iron needs with breast milk or iron-fortified soy formula. After about 4 months, the infant will need some extra dietary iron (1 milligram per kilogram of body weight per day) through a supplement. Supplemental iron should continue until the baby is eating the recommended amount of iron through solid foods. The Recommended Dietary Allowance for iron is 11 mg/day from 6 to 12 months and 7 mg/day from 1 to 3 years.

Transitioning to Solid Food

Parents can tell that their infant is ready to begin eating solid foods as the child becomes interested in foods others are eating. At this stage of development, infants can sit unsupported, pick up food and put it in their mouths, and no longer display the tongue extrusion reflex (tendency to push anything but a nipple out of the mouth). Many infants reach this stage around 4 to 6 months. Each food should be introduced one at a time, to identify any food allergies.

Iron-fortified infant rice cereal should be the first food introduced. This is not only an important source of iron, but it is also the least likely to cause an allergic response. For more information on adding complementary foods, visit www.VRG.org/Nutshell/Kids.htm and PCRM's Vegetarians Starter Kits's Vegetarian Diets for Children: Right from the Start section.



Kathryn Strong, M.S., R.D.
Kathryn Strong, M.S., R.D.


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