The Truth About Iron

Do Breastfed Babies Need Supplements?

By Gwen Morrison

Do infants who are breastfed require additional iron supplements to ensure they are receiving all the necessary dietary nutrients? If so, then when should parents add more iron to their baby's diet? How much? And why?

These are the questions nursing mothers are asking and quite often there is no easy answer.

"Exclusively breastfed babies do not need iron supplements because human milk contains iron and lactoferrin," says Rita Traina, RNC, IBCLC, a lactation consultant at the Medical Center of Ocean Family Health Clinic in Brick, N.J. "Iron absorption from human milk is more efficient than that of formula. Absorption from human milk is 49 percent of available iron, whereas iron in fortified formula only has four percent absorbed."

Traina explains that in human milk there are higher levels of vitamin C and lactose, which aid in the absorption of iron. Lactoferrin is an iron-binding protein that promotes iron absorption and utilization and inhibits the growth of iron-dependent microorganisms in the stomach such as e-coli, which can cause serious gastrointestinal problems in infants.

Most physicians feel that it is not necessary to add iron supplements or other foods to breast milk for at least the first six months.

"Pediatricians in this area do not routinely prescribe iron supplements to any child," Traina says. "Iron-fortified solid foods are introduced between 4 and 6 months of age. This is a gradual process that introduces alternative iron sources to the infant."

Marie Groves, a mother from Pittsburgh, Penn., found that her new pediatrician was concerned when told that Groves' 9-month-old son had no interest in solid foods. "Up to that point, she kept saying how big and strong and healthy he was," Groves recalls. "She couldn't get over his weight, height and that he was already walking. But the minute she heard about his eating, she acted like he was sickly."

Groves says she felt a bit embarrassed, like a child being reprimanded, when the doctor confronted her about the iron issue.

"She frowned a bit and explained how a child his age and size he weighed over 10 pounds at birth needed the proper amounts of nutrition, especially iron," Groves says. "She haughtily walked out of the room, muttering something about having the nurse check his iron levels. But I was the one who got the last laugh; his iron levels were through the roof!"

Want to see more?

• Some Breastfeeding Myths
• Breastfeeding and Other Foods
• How to Know a Health Professional is not Supportive of Breastfeeding
• Talk about it!