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Question about iron supplements??

Posted by on Apr. 25, 2013 at 1:56 AM
  • 12 Replies

I have a question maybe some other mamas might be able to help.


My baby just turned 1 and she has been exclusively breastfed for about 10 months and just started showing interest in table food within the past two months. She now eats breakfast, lunch, and dinner with me.

At her 1st year check up the doctor put her on Poly Vitamins with iron.

On the bottle it says no dairy within 2 hours of taking the vitamins.

She breastfeeds every 3 hours, so there is never a time span that she would have to take the vitamins and not have milk  within 2 hours.

The pharmacist said the Vitamin C in milk prevents the iron from being absorbed. 

I am a little uneasy giving her the supplements anyway because of things I've read about babies getting too much iron.

She was a month early so I am also curious as to why they are just now starting the supplements..I would think she would have had them earlier being as though they get enough iron in the last month from the mother to last them for the first 6 months of life. I brought this up to her pedi but she always just brushed it off saying we would wait until her first year appointment.

Any thoughts?

by on Apr. 25, 2013 at 1:56 AM
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Replies (1-10):
Junebaby18
by Nannerz on Apr. 25, 2013 at 2:00 AM
1 mom liked this
No need to give iron supplements unless the dr did a blood draw to show that she is anemic. Finger pricks are not accurate. If its not low, which I believe is below 9 or 10, then no need to give that nasty stuff.

Breast milk is also not dairy. We are not cows.
shortyali
by Alicia on Apr. 25, 2013 at 2:01 AM
1 mom liked this
I wouldn't give them unless they did a blood draw and it showed anemia. Those drops are barely absorbed and they block any absorption of the iron in your bm.
amc103
by Alli on Apr. 25, 2013 at 5:21 AM

I cant answer all your questions, but I think that pharmacist was wrong. Ive always heard that vitamin C HELPS the absorption of iron. :-/

K8wizzo
by Kate on Apr. 25, 2013 at 8:48 AM
2 moms liked this

Vitamin C helps the absorption of iron, but the fake iron in the drops blocks the absorption of the natural iron from your breastmilk.  No need for those drops, even if she has a tested iron-deficiency... give iron-rich foods instead.

Iron and Your Baby - Could your baby be at risk for Iron deficient anemia?

It is important to know that babies who may be at risk of anemia fall into the following categories:

Babies that were born premature; iiron stores build in the last few months of pregnancy.

Babies who had a low birth weight regardless of being "full term". and

Infants whose mothers were of poor nutritional status during pregnancy or who have diabetes.

So how long do a baby's Iron stores last? What about the Breast-Fed Baby?

For both formula fed and breastfed healthy full-term infants, iron stores are well maintained up until 6 months when the iron stores may then begin to deplete.  Keep in mind that while the iron baby has stored may begin to dwindle, it does not suddenly disappear! Babies who are healthy and full-term that are formula fed are seldom at risk for iron deficiencies due to the high amount of iron in iron-fortified formulas. Healthy and full-term Infants who are exclusively breastfed are also seldom at risk for iron deficient anemia especially if the baby does not begin solid foods earlier than 6 months old.

Introducing solids too early to baby may actually hinder the iron levels in the baby; most often this is related to breastfed babies.  If a baby is exclusively breastfed, then baby is getting all the iron needed up to about the 6 month mark. 

“Most breastfeeding babies do not need any water, vitamins, or iron in addition to breast milk for at least the first 6 months. Human milk provides all the fluids and nutrients a baby needs to be healthy. By about 6 months of age, however, you should start to introduce your infant to baby foods that contain iron. Your pediatrician may prescribe Vitamin D or Iron supplement if there is a need for it.” American Academy of Pediatrics. A Woman’s Guide to Breastfeeding” AAP Breastfeeding Guide 

The American Academy of Pediatrics (AAP) Breastfeeding Section recommends that infants be exclusively breast fed for the first six months of life.


Gradual introduction of iron-enriched solid foods should complement breast milk from 7 to 12 months of age [26]. Infants weaned from breast milk before 12 months of age should receive iron-fortified infant formula [26]. Infant formulas that contain from 4 to 12 milligrams of iron per liter are considered iron-fortified [27]." National Institutes of Health - Office of Dietary Supplements

How Much Iron is in the Food I Feed my Baby?

See How Much Iron is in 1 Tablespoon of the following common baby foods:
(there is approximately 14.23 grams in 1 tablespoon)Compiled from theUDSA Nutrient Database

Broccoli .09 mg
Sweet Potato .10mg
Beef .36 mg
Chicken .15 mg (light meat) .19 mg (dark meat)
Egg Yolk .38 mg

What is the Recommended Daily Intake of Iron for Baby?

The RDA for iron was revised in 2001 and is based on the prevention of iron deficiency and maintenance of adequate iron stores in individuals eating a mixed diet (11).

Recommended Dietary Allowance (RDA) for Iron
Iron Reference at Oregon State
Life StageAge Males (mg/day)Females (mg/day)
Infants
0-6 months
0.27 (AI)
0.27 (AI)
Infants
7-12 months
11
11
Children
1-3 years
7
7
Children
4-8 years
10
10
Children
9-13 years
8
8
Adolescents
14-18 years
11
15
Adults
19-50 years
8
18
Adults
51 years and older
8
8
Pregnancy
all ages
-
27
Breastfeeding
18 years and younger
-
10
Breastfeeding
19 years and older
-
9

 

Maximize Baby's Iron Absorption - Meals, Vitamin C and Iron 

Did you know Breast Milk contains Vitamin C?  It certainly does.)

As your infant grows, you can increase the absorption of iron (non-heme) from "plant" foods as well as the (heme) iron from "protein/meat" foods when a food containing vitamin C is eaten at the same meal or snack. Serving cereals with a fruit that contains Vitamin C would aid in the absorption of the iron contained in the cereal product.  

Eating foods that are high in Vitamin C will help the body absorb non-heme iron that is present in most foods served in a meal. The majority of iron that most people receive is non-heme iron; this type of iron has less bioavailability and is absorbed in smaller quantities by the body.  Get that Vitamin C working to help fully utilize Iron.

Most pediatricians in the US will recommend that you serve a fruit and a veggie together with a cereal for a meal. As baby gets older, serving a fruit, protein (such as chicken), vegetable and yogurt is a perfectly balanced meal.

FOODS THAT ARE VITAMIN C RICH

  • Citrus fruits

  • Berries

  • Green vegetables (such as broccoli and cabbage)

  • Peaches

  • Apples

  • Bananas

  • Tomatoes

  • Fortified Apple (or other fruit) Juices with Vitamin C.

Read Giving Baby Juice to learn about Fruit Juice and Your Baby

More about Breastfed Babies and Iron

“Iron deficiency is rarely seen in breastfed babies during the first six months of life. Iron is present in your milk. Although human milk does not contain large amounts of iron, it is very well absorbed. Approximately 50 percent of the iron in mother's milk is absorbed, compared to only a 7 percent absorption from formula, and a 4 percent absorption from infant cereals (Dallman 1986). Since a full-term baby's iron stores begin to diminish around six months of age, solid foods can help to meet your baby's increased need for iron and protein at that time.” Debbi Donovan - Director of ParentsPlace.com and also a Board Certified Lactation Consultant.Parent's Place Lactation Consultant

TABLE 2. Iron absorption by infants fed formula or milk (8)
Table added 07 July 2007
Substance Iron content (mg/L)  Bioavailable iron (%)Absorbed iron (mg/L)
Nonfortified formula1.5-4.8* 
~10     
0.15-0.48
Iron-fortified formula+10.0-12.8*     
~ 4 
0.40-0.51
Whole cow's milk 0.5   
~10  
0.05
Breast milk  0.5   
~50
0.25
    
* Values are given for commonly marketed infant formulas.
+ Iron-fortified formula contains >=1.0 mg iron/100 kcal formula (8). Most iron-fortified formulas contain approximately 680 kcal/L, which is equivalent to >=6.8 mg iron/L.

Taken from the CDC Recommendations to Prevent and Control Iron Deficiency in the United States
One nonrandomized study with a small cohort suggested that exclusive breast feeding for greater than 7 months is protective against iron deficiency compared with breast feeding plus the introduction of non-iron-fortified foods at age less than or equal to 7 months infants weaned to iron-fortified foods were not included in this study. Pisacane A, De Vizia B, Valiente A, et al. Iron status in breast-fed infants. J Pediatr 1995; 127(3):429-31.

"Iron in human breast milk is well absorbed by infants. It is estimated that infants can use greater than 50% of the iron in breast milk as compared to less than 12% of the iron in infant formula [1]. The amount of iron in cow's milk is low, and infants poorly absorb it. Feeding cow's milk to infants also may result in gastrointestinal bleeding. For these reasons, cow's milk should not be fed to infants until they are at least 1 year old [1].

Sources of Heme and Non-Heme Iron in a Variety of Foods

Table 1: Selected Food Sources of Heme Iron [10]
Food
(Note that 2 tablespoons equals 1 ounce  (U.S.)
Milligrams 
per serving
% DV*
Chicken liver, cooked, 3½ ounces (7 tablespoons)
12.8
70
Oysters, breaded and fried, 6 pieces
4.5
25
Beef, chuck, lean only, braised, 3 ounces
 (6 tablespoons)
3.2
20
Clams, breaded, fried, ¾ cup
3.0
15
Beef, tenderloin, roasted, 3 ounces
3.0
15
Turkey, dark meat, roasted, 3½ ounces
 
(7 tablespoons)
2.3
10
Beef, eye of round, roasted, 3 ounces
2.2
10
Turkey, light meat, roasted, 3½ ounces
1.6
8
Chicken, leg, meat only, roasted, 3½ ounces
1.3
6
Tuna, fresh bluefin, cooked, dry heat, 3 ounces
1.1
6
Chicken, breast, roasted, 3 ounces
1.1
6
Halibut, cooked, dry heat, 3 ounces
0.9
6
Crab, blue crab, cooked, moist heat, 3 ounces
0.8
4
Pork, loin, broiled, 3 ounces
0.8
4
Tuna, white, canned in water, 3 ounces
0.8
4
Shrimp, mixed species, cooked, moist heat, 4 large
0.7
4

 

Table 2: Selected Food Sources of Non-heme Iron [10]
Food
(2 tablespoons equals 1 ounce and 
8 ounces equals 1 cup  (U.S.) )
Milligrams 
per serving
% DV*
Ready-to-eat cereal, 100% iron fortified, ¾ cup18.0100
Oatmeal, instant, fortified, prepared w/ water, 1 cup10.060
Soybeans, mature, boiled, 1 cup8.850
Lentils, boiled, 1 cup6.635
Beans, kidney, mature, boiled, 1 cup5.225
Beans, lima, large, mature, boiled, 1 cup4.525
Beans, navy, mature, boiled, 1 cup4.525
Ready-to-eat cereal, 25% iron fortified, ¾ cup4.525
Beans, black, mature, boiled, 1 cup3.620
Beans, pinto, mature, boiled, 1 cup3.620
Molasses, blackstrap, 1 tablespoon3.520
Tofu, raw, firm, ½ cup3.420
Spinach, boiled, drained, ½ cup3.220
Spinach, canned, drained solids ½ cup2.510
Black-eyed peas (cowpeas), boiled, 1 cup1.810
Spinach, frozen, chopped, boiled ½ cup1.910
Grits, white, enriched, quick, prepared w/water, 1 cup1.58
Raisins, seedless, packed, ½ cup1.58
Whole wheat bread, 1 slice0.96
White bread, enriched, 1 slice0.96
gdiamante
by Group Mod - Gina on Apr. 25, 2013 at 10:28 AM
2 moms liked this

First... she doesn't need the vitamins.

Second... your milk is not dairy. While you may occasionally feel like Bessie the Cow, you most assuredly are not (you type too well to have hooves!) and human milk is not dairy. **smile**

MusherMaggie
by Platinum Member on Apr. 25, 2013 at 10:36 AM
I wouldn't give them at all. Those artificial vitamins prevent the nutrients in breastmilk from being absorbed.
Haileysmommy022
by on Apr. 25, 2013 at 1:45 PM

Lol! Thanks for the info


Quoting gdiamante:

First... she doesn't need the vitamins.

Second... your milk is not dairy. While you may occasionally feel like Bessie the Cow, you most assuredly are not (you type too well to have hooves!) and human milk is not dairy. **smile**



Haileysmommy022
by on Apr. 25, 2013 at 1:50 PM

Thanks for the replies.. She is getting lab work done today to check her levels.

Does anyone know if she will still need to take vitamins?

She has a follow up appointment scheduled next week.. I am just looking for opinions in the mean time

MusherMaggie
by Platinum Member on Apr. 25, 2013 at 1:58 PM
If she's still nursing frequently and you're offering a variety of healthy food, my guess would be she does not need vitamins. Mine never did, though they were both small. If the peso pushes you about vitamin D, just take het outside in the sun. Kellymom.com has a chart to show how much sun is needed.
stepconfused182
by Kelley on Apr. 25, 2013 at 4:47 PM
It's always better to eat foods naturally rich in a nutrient you are deficient in instead of taking a synthesized supplement. Do not give the vitamins. There is no indication. Also, the pharmacist was dead wrong. Vitamin C aids in the absorption of iron. However, the calcium in dairy can inhibit absorption of the actual vitamins in the poly vi sol. But, as others have said, your breastmilk is not dairy! Moral of the story: poly vi sol is not necessary. Get your nutrients from FOOD.
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