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Pediatricians Issue New Iron Guidelines

TUESDAY, Oct. 5 (HealthDay News) -- The American Academy of Pediatrics has issued a report that outlines new guidelines concerning the iron needs of infants and children.

The report also details new procedures for identifying and following up on signs of iron deficiency and iron anemia -- procedures that rely not just on a single test, but rather a combination of screening techniques.

"Iron deficiency remains common in the United States," report co-author Dr. Frank Greer, a former chair of the American Academy of Pediatrics committee on nutrition, said in an AAP news release. "And now we know more about the long-term, irreversible effects it can have on children's cognitive and behavioral development. It's critical to children's health that we improve their iron status starting in infancy."

"Ideally, we would prevent iron deficiency and iron-deficiency anemia with a diet consisting of foods that are naturally rich in iron," report co-author Dr. Robert Baker, a member of the executive committee of the AAP section on gastroenterology, hepatology and nutrition, said in the same release.

"Feeding older infants and toddlers foods like meat, shellfish, legumes and iron-rich fruits and vegetables, as well as iron-fortified cereals and fruits rich in vitamin C, which help iron absorption, can help prevent iron deficiency," Baker noted. "In some cases, children will still need liquid iron supplements or chewable vitamins to get the iron they need."

Greer, Baker and their colleagues presented the report recently at the academy's National Conference & Exhibition in San Francisco. Report details are also to be published in the November issue of Pediatrics.

Having dropped among American children following the introduction of iron-fortified formulas and foods during the 1970s, iron deficiency is nonetheless a problem that still affects anywhere from 4 percent to 15 percent of infants and toddlers up to the age of 3.

To prevent iron deficiency the academy recommends that breast-fed infants be given 1 mg/kg per day of iron supplementation starting at 4 months, until a child begins to consume iron-fortified cereals. Experts note that while infants have enough iron in the first four months of life, breast milk does not actually contain a lot of iron.

That said, infants on formula do not need additional iron supplementation, according to the AAP, and whole milk should not be given in the first year.

Those babies eating food between the ages of 6 months and 1 year should be given red meat and iron-rich vegetables to satisfy their need for 11 mg of iron a day. The AAP originally misstated that amount in a news release issued last week.

That need drops to 7 mg a day between the ages of 1 year and 3 years, and ideally this should also come from red meat, vegetables, and fruits with vitamin C to facilitate iron absorption. Supplements may also be given during this time, according to the academy.

Babies born prematurely should be provided a minimum of 2 mg/kg of iron daily until 1 year of age. This means that those being breast-fed need to be given a 2 mg/kg supplement daily beginning at 1 month of age, and continuing until he or she begins to eat fortified cereals or iron-rich foods, according to the academy.

More information

For more on iron and children, visit the Nemours Foundation.

SOURCE: American Academy of Pediatrics, news release, October 2010

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