Infants grow and develop rapidly and need iron in their diet to develop normally. For the first 6 months, an infant can rely on the body’s own iron supply. After that, if an infant does not consume enough iron, the body’s red blood cells suffer and their ability to support the rapidly growing body is affected. Severe iron deficiency can cause
anemia, a condition that can delay an infant’s mental, motor, and behavioral development and create problems that last long after the iron level is raised to a healthy level. Poor motor skills, behavior problems at home and school, and poor performance in school can be the long-term consequences of not receiving enough iron as an infant.
Early use and overuse of cow’s milk exacerbates existing causes of iron deficiency in infants. Less often, the problem is due to a severe blood loss or something interfering with the body’s ability to absorb iron, such as a medication the infant is taking or a chronic illness. Premature and low-birth-weight babies are at greater risk. Breast-fed babies usually obtain enough iron, unless the nursing mother’s own supply is low.
The recommendations of the American Academy of Pediatrics, the American Academy of Family Physicians, and the U.S. Centers for Disease Control and Prevention outline many specific risk factors for iron deficiency. Most of these groups do not call for all infants to be tested; rather, they recommend screening infants with known risk factors and those at high risk. In general, if an infant meets any of the following criteria, his or her iron stores should be checked via a blood test between 6 to 12 months of age:
Born prematurely or had a low birth weight
Parents are migrants, recently arrived refugees, or immigrants from developing countries
From a household with a low income or living in poverty
Is fed cow’s milk before 12 months of age or given more than 24 ounces of cow’s milk per day after 12 months of age, fed infant formula that was not fortified with iron for more than 2 months, or breastfed for more than 6 months from a mother low in iron
Takes medication that interferes with iron absorption, had extensive blood loss, has a chronic infection or inflammation, or is on a restricted diet
In some settings, the health care provider may prefer to screen all infants and young children, following the American Academy of Pediatrics recommendation. The age at which the iron deficiency anemia testing is done often depends on the risk factors present. If the infant was born prematurely or had a low birth weight and is fed formula without iron, the baby’s iron stores may run low sooner than most, before 6 months of age. In other circumstances, later testing (between 9 and 12 months of age or 15 and 18 months of age) may detect the problem. A retest 6 months later is also sometimes needed.
Link
American Academy of Family Physicians: Iron deficiency anemia in infants and children: how to prevent it
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