However recently we had a case of a 33+6 prem breast fed baby with delayed weaning who had an Hb of 5g/dl which was attributed to dietary causes. They weren’t in receipt of routine iron suppl which is recommended for prem babies <34 wks as they were well enough never to have been admitted to the neonatal unit. Should that 1 day difference in age have been so significant? I do think
breast fed babies are at greater risk of iron deficiency in the first year cmf iron fortified formula if not weaned onto a mixed diet incl iron rich foods promptly from 6 mths age (5-7mths actual age in prems).

I would love to hear your thoughts on this.
Thank you

Hi Sarah,

Iron-deficiency anemia can happen among breastfeeding toddlers, usually in those who are slow to incorporate iron-rich complementary foods into their diets. But I’ve never seen an extreme iron-def anemia in these kids attributable to excess breast milk intake.

The explanation for this probably relates to 1) although breast milk is quite low in iron, the iron in breast milk is exquisitely well absorbed by baby’s GI tract, and 2) breast milk (even in large amounts) doesn’t cause microscopic gastrointestinal bleeding in the way that excess cow’s milk intake does.

Thanks for the great question.

Calcium can inhibit the absorption of iron (especially the non-heme, or plant-based iron variants) when both of these minerals are consumed at the same time. But for most of us, this effect is not usually large or significant. In other words, most of the time, co-consuming dairy and iron-containing foods won’t cause anemia for those of us eating healthy balanced nutrition. On the other hand, if you have iron-deficiency anemia and are finding it hard to consume enough iron to correct the problem, then even small improvements in iron absorption can make a big difference.

So the practical take-home message is: if you do not have iron deficiency anemia and are eating healthfully, then don’t worry about co-consuming dairy and iron-containing foods. If you are iron deficient and struggling to get enough iron into your system, then separating your dairy intake from your iron intake may very well help to improve your iron-deficiency.

Thanks for the great question.

Since we are talking about milk and calcium, is it true that we shouldn’t mix milk with iron reach foods (like cereals) because calcium from milk inhibits the absorption of iron ? I am asking because I have seen it in many articles and I am trying to keep my toddlers from getting anemic because of wrong food combinations. :d

Thank you!