Parents of toddlers are frequently putting their irons into the fire and asking me questions about how to prevent their child from getting iron deficiency anemia. Well, being the iron man that I am – not – let me provide some information on this topic.

Iron is needed to build up your red blood cells to bring oxygen into your body. Without enough red cells, your body does not get enough oxygen and begins to feel weak and tired. Recent studies have shown that even a mild decrease in iron stores may affect your child’s brain growth and impact their ability to pay attention, stay alert and learn.

The most common reasons for iron deficiency are not eating enough foods that contain iron or needing an extra supply for growth, which is why this problem is most commonly seen in infants and teens, especially teen girls. In fact, recent studies suggest that as many as 12 to 15 percent of infants and toddlers may be iron deficient.

So what can be done about this? The American Academy of Pediatrics recommends varying the amounts of iron based on a child’s age. For example, infants in their first year of life need 11 milligrams of iron daily. If infants are being exclusively breastfed, they will likely need to be started on an oral iron supplement anywhere from 1 month of age, if a preterm infant, and no later than 4 months of age, if term.

Iron-fortified solids like cereals are started around 6 months of age. Your baby’s doctor can help determine the right amount of iron for your baby if you are exclusively breastfeeding for the first six months of your baby’s life (which hopefully you are).

Infants on formula should have enough iron in their formula to meet the 11 milligram requirement and not need an oral supplement prior to starting solids. Most importantly, no baby, breast- or formula-fed, should be started on whole milk before a year of age. Whole milk is low in iron and can decrease the absorption of iron from other foods if more than 24 ounces are drunk a day.

Toddlers and children up to age 12 need 7-10 mg of iron a day, which they can get from lean red meats, fish, poultry, green leafy vegetables and iron-fortified breads and cereals. During adolescence, the daily iron requirement goes up again with males needing 12 mg and females 15 mg a day. Athletes may need more.

Hopefully tips like this will iron out any questions you might have when it comes to making sure your infant or child gets enough iron.

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Larner College of Medicine at UVM. You can also catch “First with Kids” weekly on WOKO 98.9FM and WPTZ Channel 5, or visit the First with Kids video archives at

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the Robert Larner, M.D. College of Medicine at the University of Vermont.

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