In all of the baby-led feeding research I've done over the last few years, there seems to be a gap in reliable info when it comes to BLW and iron. Healthy, full-term babies are born with enough iron stores to last around 6 months. After around 6 months, breastfed babies get their iron from food. Right? That's what I thought until a friend casually asked what brand of iron drops I give Bobby, my 7 month old. I immediately took to Google which doesn't even help because you can literally find a seemingly legit research study for a-ny-th-ing. I even took a 4 hour infant feeding course for nurses, lactation consultants, and dietitians, and in the two seconds iron came up, the speaker's answer left me thinking "wait...so what is your recommendation?".
The American Academy of Pediatrics recommends an iron supplement for all breastfed babies (1 mg/kg/day beginning at 4 months ). ALL of them. This is based on the concern that breastfed babies may end up anemic because breast milk is technically low in iron. The thing is, they typically don't. Breast milk is low in iron if it is broken down into components like it was just a box of cornflakes, but breast milk isn't like just any old food. If there were ever a true superfood, breast milk would be it. This wonder beverage has exactly the right amount of vitamin C and lactose to make iron absorption super efficient (way more efficient than supplemental iron). It's hard for me to grasp that it all of a sudden leaves our babies hanging without a super important nutrient as soon as they turn 6 months old.
I chose to forgo supplementation and put my trust in the amazing sorcery of breast milk combined with food sources of iron. Ruthie, my 2 year old, was born at 37 weeks, small at birth, and exclusively breastfed through 6 months without supplementation of iron. After 6 months, I began slowly introducing foods (including fortified baby oats every now and then) but mostly relied on iron rich seeds, fruits + vegetables, and meat. I wasn't a nut about it, I didn't have a log where I jotted down her daily intake of all nutrients. What I did do was re-learn what foods are high in iron, and throw them into the mix every week. At Ruthie's 12 month hemoglobin check, her iron levels were perfect.
The slightly anticlimactic bottom line is that it is completely up to you and your physician to choose supplementation of iron. If you ensure that your beautiful breastfed little cherub is eating iron rich foods while continuing to breastfeed, I believe that you can get your baby all of the iron they will need.
Tips for getting the most iron out of a baby-led diet:
1. Don't let concern of getting any certain nutrient ruin the fun and excitement of feeding your babe. Eating a lot of different foods over the course of the week will almost always get you where you need to go.
2. Include both plant and animal based iron. I tend to offer my 8 month old a lot of plants, but the type of iron found in animal products is a little more efficiently absorbed. (see below for options).
3. Serve iron rich foods with fruits and vegetables. Vitamin C increases absorption of iron (vitamin C is found in almost all fruits and vegetables, so if your babe is eating fruits and vegetables over the course of the day, you are likely covered and are also an amazing person and mother for this and many other reasons).
4. Avoid cows milk before age one (yogurt and cheese are great, just not milk yet).
11 Iron Rich Ideas Perfect for Baby-led Weaners
1. Sub some baby cereal for flour when making pancakes, waffles, or banana bread.
2. Use blackstrap molasses to lightly sweeten foods like pancakes, waffles, or oatmeal (it's SO good - I put it in coffee with cream sometimes).
3. Mash beans and form into patties for easy pickup.
4. Bake lentils into mini loaves that are easier to pick up, or simply cook and mash.
5. Make mini meat loaves in a muffin tin.
6. Roasted, unsalted seaweed strips (try wrapping them around avocado).
7. Roll avocado in ground flax seed (makes it easier for babe to pick up! Or if you're my babe, to smash into smithereens) or stir flax into yogurt or oatmeal.
8. Mix chia seeds with a little orange or prune juice and allow to thicken into a pudding.
9. Cook with a cast iron skillet. It adds dietary iron especially to acidic foods.
11. Three words: Prune Jello Jigglers (picked this one up as an intern at a retirement home).
12. Blend a smoothie with kale or spinach + fruit.
You guys, we all have that well-meaning friend who says things that make us feel like they're saying "WHAT OMG YOU'RE NOT FEEDING YOUR KID SEA URCHINS?!" or "KAREN WTF THAT GENERIC DIAPER CREAM IS GOING TO BURN A HOLE IN YOUR BABY...I SAW IT ON THE NEWS". I don't want to be that friend to you. I just want to share what I've learned to do well or have completely messed up as I feed these little guys. You hold 100% of the feeding power. Learn what you can but do what you feel is best and what works for you.
I'm over here covered in crumbs and unidentifiable sticky patches if you ever need me.
As always, this information is general in nature and intended to share my experiences. If you are concerned your child isn't getting enough iron, please talk to your child's pediatrician or make an appointment with me.