Babies are at risk for iron deficiency (ID) or iron deficiency anemia (IDA) due to rapid growth and not eating enough iron-rich foods in their diet.
Pre-term babies and low-birth weight babies are at greater risk for ID and need iron as they do not have as much iron stored as full term babies. Typically these babies have enough iron stores to last until 2-3 months of age. While, most term babies that are exclusively breast-fed will have enough iron stores to last between four to six months of age.

In the Fall of 2010, there was a recommendation from the American Academy of Pediatrics Committee of Nutrition for term breast-fed babies to start an iron supplementation at 4 months of age until they start eating iron-rich solids. The Canadian Paediatric Society also notes the recommendations from the AAP committee in their resource for ‘Primary prevention for Iron deficiency anemia in children’ http://www.cps.ca/english/surveillance/cpsp/Resources/Iron-deficiency_anemia.pdf

Additional factors such as maternal history of iron deficiency, poor maternal diet, low socioeconomic status, early introduction of cow’s milk can impact babies iron stores. We recommend having a discussion with your healthcare professional during the 4 month check to determine if your baby needs an iron supplement and to start the discussion about introducing solids. When starting solids at 6 months, make sure to offer iron fortified cereals, iron rich vegetables and to introduce meat options by 7 months of age. Your baby’s healthcare professional may decide to check your baby’s iron level to screen for iron deficiency at 9 or 12 months of age depending on risk factors.