Iron and breastfeeding

Given the importance of iron nutrition during the first year of life, there are relatively few true randomized controlled studies addressing this issue; however, it appears that iron deficiency is unlikely to occur in the full-term breastfed infant during the first 6 months of life because the infant's body iron stores are sufficient to meet requirements. After this time, many infants exhaust their iron stores and become dependent on a secondary dietary iron supply. Although iron deficiency is a significant nutritional problem worldwide, most of the adverse effects of iron deficiency in this age group are hypothetical and rely on extrapolation from animal studies or studies at different ages. This, however, is also true of most of the adverse effects of iron excess in this age group. Given this uncertainty, it seems prudent to use the lowest dose of iron that prevents iron deficiency anemia. Currently, the best evidence is that this is achieved by prolonged breastfeeding, avoidance of unfortified formulas and cow's milk, and the introduction of iron- and vitamin C-fortified weaning foods at approximately 6 months of age.