The American Academy of Pediatrics (AAP) has updated its iron-intake guidelines for infants and children 3 years old and younger to help physicians and parents prevent iron deficiency and iron deficiency anemia in these children.
According to the guidelines, term, healthy infants who are exclusively breastfed should receive 1 mg/kg oral iron per day beginning at age 4 months. Iron supplementation should continue until appropriate complementary foods that contain iron are included in the child's diet. Appropriate foods include baby foods that include meat, vegetables, and cereal and table foods such as beans, oatmeal, and other iron-rich fruits and vegetables. The diet also should contain vitamin C-rich foods to help improve iron absorption.
Infants whose daily feedings consist of more than half breast milk and who have not begun eating appropriate complementary foods also should receive 1 mg/kg oral iron per day.
Iron supplementation is not necessary for term, healthy infants who are exclusively formula-fed and are introduced to appropriate complementary foods beginning at 4 to 6 months.
Infants aged 6 to 12 months need 11 mg iron per day. This requirement can be met through diet or diet and supplementation. When adding appropriate complementary foods to the child's diet, parents and caregivers should be encouraged to introduce iron-rich vegetables and red meat early in the process.
For toddlers, diets should provide the recommended 7 mg iron per day. Supplements and chewable vitamins (for children aged ≥3 years) are appropriate.
Preterm infants should receive at least 2 mg/kg iron per day through age 12 months, which is the amount supplied in iron-fortified formula. Preterm infants who are breastfed should start receiving 2 mg/kg iron supplement per day beginning before age 1 month and continue until the infant is weaned to an iron-fortified formula or appropriate complementary foods are introduced to the diet. These guidelines do not apply to preterm infants who receive an iron load from multiple transfusions of packed red blood cells.
The guidelines, published online October 5 in Pediatrics, recommend anemia screening for all children at approximately 1 year of age. The screening should include a hemoglobin concentration test and an assessment of developmental and environmental risk factors.