Nine out of 10 infants not meeting recommended daily iron intake

Tim Robertson

20/05/2022 6:24:01 PM

But are the guidelines realistic and how concerned should parents and clinicians be?

Toddler eating red meat
A quarter of toddlers are failing to meet the recommended daily iron intake.

New research conducted by the South Australian Health and Medical Research Institute (SAHMRI) suggests all infants and a quarter of toddlers are failing to meet the recommended daily iron intake.
While the report, supported by a grant from Nestlé Nutrition Institute and based on interviews with 1100 parents who documented their children’s diets shows the majority of children are getting the right amount of most nutrients, the authors describe the iron intake findings as ‘a concern’.
‘We found 90% of infants 6–12 months old were consuming far less iron per day than the recommended amount,’ Dr Merryn Netting, a paediatric dietitian and the study’s lead researcher said.
‘Not getting enough iron is a concern because we know iron deficiency negatively impacts overall development. It can also cause tiredness, loss of appetite as well as poor growth and lead to anaemia, a condition that reduces oxygen in the body.’
Dr Bambi Markus, a Sydney-based GP with a special interest in obstetrics and gynaecology, believes the findings warrant further investigation.
‘It is not common to test babies and toddlers for iron deficiency, compared to older children or adults,’ she told newsGP.
‘[Instead] you are relying on symptoms that parents complain about or you may be relying on your biodata when following up a child and you are concerned about how the child is thriving – whether there is an issue with weight gain … [or] meeting their milestones;
‘Their activity level, especially when they start crawling and walking [is another important marker].’
While further research is required, Dr Markus cautions against being too alarmed over SAHMRI’s findings concerning the 90% of infants aged 6–12 months who are consuming less iron than recommended. She also points to a 2016 study that found only 32.6% of infants and 18.6% of toddlers had inadequate iron intake.
‘It is a difficult age at which you are trying to introduce ... solids to babies,’ she said.
‘It can be very difficult you start introducing new things. There are a lot of challenges parents are met with in terms of what the baby will and will not have.’
The recommended daily iron intake is based on the National Health and Medical Research Council (NHMRC) guidelines that recommends infants consume 7 mg of iron each day. To achieve this amount of iron, infants need to eat around 300 g of beef or 400 g of fortified cereal.
‘It’s possible the recommended iron intake has been set higher than needed and should be reviewed,’ Dr Netting said.
‘But we won’t be able to confirm if this is the case without doing further studies with a larger cohort of infants.
‘We have no data on blood iron levels or anaemia in this group, and we urgently need it. If iron levels are low, we may need to consider giving infants iron supplements.’
The recommendation broadly aligns with the guidelines Dr Markus follows, which recommend 0.2 mg for infants 0–6 months old, 11 mg for infants 7–12 months old and 8–9 mg for children aged 1–3 years old.
In contrast to a lack of iron, the study also reports that around a third of toddlers are consuming too much salt.
‘Too much salt is typically down to eating an excess of processed foods,’ Dr Netting said.
‘Children will develop a taste for salty foods that are often unhealthy. This can contribute to poor eating habits down the road, as well as high blood pressure.’
Many parents are busy working and juggling multiple commitments, which means it is not always possible to prepare and cook for their children. But healthcare professionals can help educate parents on how to read labels.
‘A lot of the labelling on infant food is confusing and misleading,’ Dr Markus said.
Healthcare professions can provide parents with a benchmark level of salt content and recommend opting for foods that don’t exceed it.
On the positive side, breast feeding rates surpassed expectations, with 75% of mothers shown to be breast feeding at six months and 50% at 12 months.
‘It’s very pleasing to see that so many mothers are opting for breastmilk with all the added nutrients it provides, rather than reaching for baby formula,’ Dr Netting said.
Healthcare professionals should ‘advocate and encourage breastfeeding’ and, while these numbers are ‘excellent’, Dr Markus believes they are likely dependant on the demographic makeup of the cohort.
It can be a contentious issue and, when dealing with young mothers, healthcare professions should be tactful and delicate, Dr Markus said.
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