Does My Baby Need an Iron Supplement?

Not getting enough iron, also known as iron deficiency, is one of the most common nutrition problems in infants and children worldwide. The good news is that iron deficiency can be prevented. Keep reading to learn why iron is so important and how to ensure your child is getting enough.

The importance of iron

Iron, a nutrient known as a mineral, has many essential bodily functions. For example, our body needs iron to make hemoglobin, the protein in our red blood cells that carries oxygen throughout the body. In addition, iron plays an important role in brain development and in making hormones. It is also a nutrient that can help the body fight infection.


A decrease in the amount of iron stored in the body can eventually lead to anemia (a low level of red blood cells). This type of anemia is called iron deficiency anemia. Research shows that babies and young children with iron deficiency anemia can have difficulty fighting infection. Research has also linked infancy and early childhood anemia to lower cognitive and motor function.

Experts agree that preventing iron deficiency anemia is much more effective than treating it.

Why do some babies have low iron levels?

During pregnancy, babies receive iron from the mother’s blood and store it in their bodies. Doctors call the amount of iron stored in the body “iron stores.” These iron stores can be affected by a number of factors, including:

  • Premature birth. When babies are born prematurely, they do not have as much time to increase their iron stores before birth.
  • Low birth weight. Babies born with low birth weight do not have as much iron stored in their bodies even if they are born at term.
  • Anemic mother. Infants born to mothers with anemia may also have lower iron stores.

Breastmilk alone may not provide enough iron for these babies. As a result, they may develop iron deficiency anemia without an additional iron source, such as a supplement or iron-fortified formula.

Most babies born at term and average birth weight will have enough iron stores to last until they are ready to start solid foods. Babies need to have iron-rich foods by about six months to replenish their iron stores and prevent anemia. A high amount of cow’s milk in the diet can contribute to low iron levels because infants and children who fill up on cow’s milk may not consume enough iron-rich foods.

How do I know if my baby has low iron?


If your baby was born premature or at a low birth weight, your baby’s healthcare provider may check their iron or hemoglobin levels before your baby goes home from the hospital. However, most term babies will not need these tests.

Low iron levels typically develop well after birth once iron stores are depleted. So, your child’s doctor will watch for symptoms of low iron and anemia over the first months and years of life. The doctor or healthcare provider will look for risk signs, such as diets low in iron or other health conditions that could cause anemia.

Some symptoms of iron deficiency anemia include:

  • Pallor (pale skin)
  • Fatigue
  • Poor feeding in babies
  • Headache
  • Shortness of breath

How to know if your baby needs an iron supplement

Most term babies with an average birth weight will not need an iron supplement. This is because term babies are born with enough iron stores in their bodies to last them about six months. They will then need iron-rich foods to keep their iron levels healthy.

Premature or babies born with a low birth weight may need an iron supplement. Breast milk is a healthy choice for all babies. However, it does not contain enough iron for babies with low iron stores. A doctor may recommend an iron supplement if your baby was born prematurely or with a birth weight of less than 2.5 kg (or about 5 pounds).

Infant formula contains more iron than breast milk. So, if your baby is formula-fed, they may get enough iron from their diet, even if they are premature or have a low birth weight. Your baby’s healthcare provider will tell you if your baby needs iron.

Low iron levels are a widespread problem. However, iron-rich foods and, for some babies, an iron supplement can prevent iron deficiency. Talk to your child’s doctor if you have any concerns, and always follow medical instructions if they recommend an iron supplement.


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