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Pankaj Arora (@pankajarora)

Iron Supplementation Guidance for Infants

About Kids & Teens | Last Active: May 27, 2019 | Replies (8)

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@astaingegerdm

@pankajarora
I believe the AAP guidelines refer to full term, healthy infants. For exclusively breastfed infants iron supplementation should start at 4 months and continue until solid foods that are iron fortified are started after 6 months of age. The infant is born with an iron store from the mother lasting about 4 months. Formula fed infants can be fed formula with iron.
Premature infants don’t have much of iron store and need supplement from the start.

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Replies to "@pankajarora I believe the AAP guidelines refer to full term, healthy infants. For exclusively breastfed infants..."

Thanks for your response. You are correct, that is the AAP guidelines. However, the WHO, Canadian Pediatric Society, and many Pediatricians say don't bother at four months for full term healthy BF infants. There seems to be more consensus around six months and utilizing solid foods (incl fortified ones) where possible.

It is also disputed within the AAP as well. Here's a good summary article: <Search for "Experts Challenge AAP Iron Supplement Policy"> and here's the AAP editor letter that originally challenged the guidance: <Search for "Concerns With Early Universal Iron Supplementation of Breastfeeding Infants"> (I would have posted direct links but apparently new members can't do that). There are also some sources online that seem to imply universal supplementation at four months could even be detrimental.

Again you are correct in reciting the AAP guidance, which confusingly our Pediatrician, and a few others we spoke to, suggested we don't adhere by – which is at the root of our concern on this matter for us and other parents given the conflicting advice.