There are only two medically acceptable ways to feed an infant less than one year of age in the modern world today. One is to breastfeed. The other is to use an approved iron fortified infant formula based upon cow’s milk, soy protein, or protein hydrolysate. Either way strained solid foods should be introduced gradually starting between 4 and 6 months of age, and should include meats and iron fortified infant cereals by the time a significant reduction in the child’s total intake of formula or breast milk occurs.

Iron is a very important element to the body. Lack of iron can harm a child, and particularly a child’s brain. The most famous role for iron is in the formation of red blood cells. If you don’t have enough red blood cells due to a lack of iron, we call this Iron Deficiency Anemia.This is a relatively silent but quite serious condition, especially for a child, because the ability of the blood to deliver oxygen to the tissues is impaired. Under 4 years old the part of the child growing fastest, and therefore most vulnerable to a lack of oxygen delivering capacity, is the brain. Evidence suggests that by the time a child becomes anemic, harmful effects on brain cells have been going on for quite some time already. Long term studies have shown that children who experience Iron Deficiency Anemia during the first five years of life have lower I.Q. scores and a higher incidence of learning disabilities and other neurodevelopmental deficits than do iron “sufficient” children. Such neurological complications of iron deficiency are permanent and irreversible.

It is because of the information above, that the American Academy of Pediatrics strongly recommends all infant formula sold in the Unites States should be iron fortified. They also endorse breastfeeding and delaying the introduction of whole milk until one year of age.

Given we now have strong evidence to show feeding an infant breastmilk or iron-fortified formula prevents both anemia and iron deficiency, we do not recommend the use of ‘low iron’ formulas. ‘Low iron’ formula contains essentially zero bioavailable iron, much less than even natural human breast milk. Feeding your baby ‘low iron’ formula could be harmful and detrimental to their health and development.

What about side effects from iron? Many of you may believe or have heard that it causes constipation, diarrhea, colic, and numerous other unpleasant symptoms. However, there is no scientific evidence for this. In fact, studies have been done giving mothers un-labeled bottles of both iron-fortified and low-iron formula to feed their babies at different times- neither mother’s nor babies seemed able to tell the difference. The “old wives tale” about iron comes from the fact that in a treatment dose (the amount I would prescribe as a pill or drops for a diagnosed iron deficiency) it will indeed cause some gastrointestinal upset in certain individuals at times. It is important to note that the amount of iron in iron-fortified formula or breast milk is a nutritional dose, however, many times lower than a treatment dose. Nutritional doses are enough to prevent, not treat, iron deficiency. The nutritional amount of iron in iron fortified formula is roughly equivalent to what an adult would get simply by eating red meat at 3-4 meals per week