Key takeaways: Iron stores from birth start running low around 4 to 6 months. Iron supports brain development and healthy blood. Offer iron-rich foods at most meals: meats, beans, lentils, tofu, eggs, and iron-fortified cereals. Pair them with vitamin C foods to boost absorption.
Iron is one of the most important nutrients when your baby starts solids. Here’s why, and how to make sure your baby gets enough.
Why Iron Matters
Iron helps make hemoglobin, which carries oxygen in the blood. It’s also essential for brain development. Iron deficiency in infancy has been linked to delays in development that may not be fully reversible.
Babies are born with iron stores that last about 4 to 6 months. After that, they need iron from food (or supplements). Breast milk contains small amounts of well-absorbed iron, but not enough for older babies’ needs. Iron-fortified formula provides more.
Who’s at Higher Risk?
- Exclusively breastfed babies after 4 to 6 months without iron-rich foods.
- Premature or low-birth-weight babies.
- Babies whose parents had low iron in pregnancy.
- Babies who drink cow’s milk before 12 months, or too much cow’s milk after 12 months.
Iron Supplements
The AAP recommends that exclusively breastfed babies receive an iron supplement (1 mg/kg/day) starting at 4 months until they eat enough iron-rich foods. Premature babies need supplements earlier. Talk to your baby’s doctor.
Two Types of Iron
- Heme iron: found in meat, poultry, and fish. It’s absorbed well.
- Non-heme iron: found in plant foods and fortified cereals. It’s absorbed less easily, but vitamin C helps.
Best Iron-Rich First Foods
Heme iron:
- Pureed or finely shredded beef, lamb, chicken, or turkey (dark meat has more iron).
- Liver, in small amounts.
- Flaked, boneless fish like salmon or sardines.
Non-heme iron:
- Iron-fortified infant cereals (oat, barley, multigrain).
- Beans and lentils, mashed.
- Tofu.
- Eggs.
- Dark leafy greens, cooked and pureed.
- Nut butters (thinned, for babies without allergy concerns).
Boosting Absorption
- Pair with vitamin C: offer iron-rich foods with fruits and vegetables like strawberries, oranges, tomatoes, broccoli, peppers, and kiwi.
- Don’t overdo milk after 12 months; too much cow’s milk can reduce iron absorption and appetite.
- Use a cast-iron pan for cooking; it can add some iron to foods.
Sample Iron-Rich Combinations
- Oatmeal (iron-fortified) with mashed strawberries.
- Shredded chicken with sweet potato and peas.
- Lentils with tomato.
- Scrambled egg with diced soft pepper.
- Mashed beans with avocado.
Screening for Anemia
The AAP recommends screening for anemia around 12 months with a simple blood test. Your doctor may test earlier if your baby is at higher risk.
The Bottom Line
Iron needs rise around 6 months. Offer iron-rich foods at most meals, pair them with vitamin C, and talk to your doctor about supplements, especially for breastfed and premature babies.
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Sources
- Baker RD, Greer FR; Committee on Nutrition. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010;126(5):1040-1050.
- US Department of Agriculture and US Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025, Chapter 2: Infants and Toddlers. https://www.dietaryguidelines.gov
- Lozoff B, Beard J, Connor J, Felt B, Georgieff M, Schallert T. Long-lasting neural and behavioral effects of iron deficiency in infancy. Nutr Rev. 2006;64(5 Pt 2):S34-S43.
- Domellöf M, Braegger C, Campoy C, et al; ESPGHAN Committee on Nutrition. Iron requirements of infants and toddlers. J Pediatr Gastroenterol Nutr. 2014;58(1):119-129.
- World Health Organization. WHO Guideline for Complementary Feeding of Infants and Young Children 6-23 Months of Age. Geneva: WHO; 2023.
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
