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Iron deficient anemia and vegetarian infants

An infant is born with iron sufficient enough for first six months. During these six months, the infant uses the stored iron and the iron from the diet to grow normally.  After six months, an infant may suffer from iron deficient anemia.
A mother cannot increase the level of iron in breast milk by her own iron intake.
Symptoms of infant anemia include:

Pale skin (specially the earlobes) and paleness of mucous membranes
Lethargic

Frequent illness
Loss of appetite

 

Pediatricians may check the iron level of infant after the age of 9 months, and may prescribe iron drops.

 

Causes

Not enough iron at birth

During the 3rd trimester, infants start to store iron that would last the needs of of the infant  for up to post natal six months in addition to the iron in the breast milk. Common cause for insufficient iron at birth are: Premature birth, birth weight below 6.5 pounds, multiple gestation, anemic mother during pregnancy, poorly controlled mother's diabetes.

 

Early weaning to cow's milk

This is the most common cause, when a mother weans off the infant from breast milk to cow's milk after six post natal months. Cow's milk is low in iron, and the iron in cow's milk is less bio-available. Cow's milk also decreases the iron bio-availability for other dietary sources.

Even babies on exclusive cow's milk between 12 and 24 month are at risk.

 

The breast milk is low in iron, but it increases iron bioavailability by 50%. The breast milk two proteins: lactoferrin and transferrin. These proteins increase the bio-availability of iron. In addition, breast milk also has lactose and vitamin C, which further enhance iron bio-availability. The iron in the infant formula is about 4% lower in bio-availability. The infants must be given iron-fortified cereal, iron-fortified formula till the age of 12 months.

 

Required Intake (RNI)

Amount of Nutrition intake for 97% of the population

0 to 3 months: 1.7 mg/day

4 to 6 months: 4.3 mg/day

7 to 12 months: 7.8 mg/day

1 to 3 years: 6.9 mg/day

4 to 6 years: 6.1 mg/day

7 to 10 years: 8.7 mg/day

 

Dietary Sources

 

Vitamin C increases the bio-availability of iron. The best source for Vitamin C are red bell pepper, and tomatoes. Bell peppers may be used to cook vegetable curries.

 

Cereals: In United States, you can choose iron fortified Rice. In Indian cuisine, you can use brown rice, Ragi, Bajra. After the age of 12 months, you should be able to switch over to Wheat  and Barley products.

 

Fruits: The best choice is Avocado.

 

Vegetables: Green peas, Tofu, Dried beans, Dark green vegetables (spinach, mustard greens),  Sweet Potatoes, Broccoli, Potatoes, Winter squash (Indian Kaddu, Butternut, Hubbard, Mushrooms

 

Proteins: Dal (Toor, Moong, Chana), Soya beans, Tofu, Egg yolk

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