Katie Ferraro (0s):

And parents will hear this recommendation. Oh my seven to 12 month old baby needs 11 milligrams of iron and they'll read labels and they realize, oh my gosh, like most foods only have at most one milligram of iron and my baby is not even that much, there was no way they are getting enough iron. Chill. They will learn to eat enough iron. Hey there, I'm Katie Ferraro, Registered Dietitian, college nutrition professor, and mama of seven specializing in baby led weaning. Here on the Baby-Led Weaning Made Easy podcast I help you strip out all of the noise and nonsense about feeding, leaving you with the competence and knowledge you need to give your baby a safe start to solid foods using baby led weaning.

Katie Ferraro (42s):

Hey guys, and welcome back! Today, we're talking about iron and whether or not your baby can get enough iron from baby led weaning foods and iron is a major pain point for parents and iron status and iron intake, something many parents and caregivers worry about when they're just to starting solid foods. But in today's episode, we're going to talk a little bit about iron needs. The real truth about iron needs, how babies can meet those needs from foods when they're starting baby led weaning. And then how do you determine whether or not your baby is getting enough iron from solid foods? So with no further ado, let's dive into iron and can my baby get enough iron from baby led weaning foods ? Now I'd like to start each of these mini baby led weaning trainings with a BLW tip of the day.

Katie Ferraro (1m 28s):

Today's tip about iron is your baby does not actually have to eat the 11 milligrams of iron that you read all over the place the babies need from seven to 12 months, the parents will look it up and they'll say, oh my baby, who's age seven to 12 months. It needs 11 milligrams of iron. And then they automatically think that it all has to come from food. And that is really far from the truth. Remember, breast milk and or formula is still providing most of your babies's nutrition needs during weaning. And that includes iron. So if you're breastfeeding, your breast milk has iron. Although it's not a ton of iron, it's actually very highly bioavailable, meaning your baby absorbs a lot of the iron from your breastmilk. And if your feeding formula, formula is of course fortified with iron, it's actually fortified it 12 milligrams of iron per liter.

Katie Ferraro (2m 12s):

So a liter, which is the thousand ml is approximately 34 ounces, basically about what most six month babies are drinking, give or take a few ounces. So as we add in foods and babies learn to eat foods, including high iron foods, then gradually the amount of nutrition, which is calories plus other nutrients, including iron, that nutrition starts to come more from food and less from milk that's weaning inaction, but if you're not introducing iron foods to your baby, then as the breast milk or formula intake declines, as it should with weaning, we could be in trouble if you're not making up that gap with iron foods. So early on in feeding, please don't stress about this 11 milligrams iron number. I'm going to talk more about the 11 milligram number in a second, your baby will get there I promise, but it doesn't happen overnight and hang tight!

Katie Ferraro (2m 58s):

Because in this episode, I'm going to be sharing some on good iron foods for baby Led Weaning that you can be practicing with early on, even when breast milk or formula is still meeting most of your babies's nutrition needs including iron needs. And when your baby is just learning how to eat. So I want to tell a story real quick to is that I know from my experience as a dietitian, as a mom, as a specialist in baby led weaning for years now that almost every parent and caregiver has the fear that if they are skipping iron fortified rice cereal, that the baby's iron levels are going to come back low. And I know it happened to me. I actually had a baby with iron levels that were suboptimal, and I want you to know it's not the end of the world. And it wasn't because I wasn't doing my job.

Katie Ferraro (3m 38s):

So I did baby led weaning with six of my seven kids and on my seventh babies, 12 month checkup, like my last baby last baby checkup. My twin daughter, Hannah had her in office heel prick test to test her hemoglobin, which is an iron value and hemoglobin supposed to be above 12 and Hannah's was 9. And as I do, because I'm kind of an obnoxious patient I requested to redraw and that it came back at 10 and then I requested another redraw and that came back to 10. And then I have to accept that. Yes, my baby's hemoglobin level is suboptimal. At that point. My pediatrician recommended iron supplements. I have a great relationship with my pediatrician, but I declined the suggestion because Hannah was actually already struggling with constipation, which was affecting her intake and iron supplements, which can make constipation worse.

Katie Ferraro (4m 21s):

We're just going to make her eat less food, which in turn, was going to make the iron situation worse. So what we ended up doing was a trial for about 6 weeks where we intensively used food to help fix Hannah's hemoglobin levels. The half-life of hemoglobin is about 21 days. You can't do it overnight. It takes a little while to get them back up. I actually wrote a whole mega blog post about this called low iron level, baby bootcamp. If you wanna follow the whole course, that's all there with all of the pictures and the videos, iron checks all about the foods that we used, how we altered the sequence of her foods. I'm going to link to that blog post about the low iron level baby boot camp and the whole sequence that we use. I'll put that on the show notes for this episode would, you can find at the blwpodcast.com/137.

Katie Ferraro (5m 3s):

So before you freak out, if your baby's iron comes back a little low at the pediatrician, please know that it happens. And it's totally fixable. That whole blog post has way more info about screening for anemia and checking iron levels and hemoglobin levels at your pediatrician's office. Now let's just talk briefly about iron deficiency because that's what we're trying to prevent here. And iron deficiency is the most common micronutrient deficiency worldwide. So a micronutrient is something like a vitamin or mineral that you need in very small amounts in the diet or the body in some cases can make. But the point is, even though you need very small amounts are still very important. And so if we look at the NIH statistics, National Institutes of Health, about 12% of infants aged, six to 12 months in the U S have inadequate iron intake and will talk about why that is it generally not in the first six months of life, it happens in the second six months of life and spoiler alert it's because they're not being introduced to foods that have adequate iron in them.

Katie Ferraro (5m 58s):

So who is at risk for iron deficiency? Your baby is at higher risk of having iron deficiency. If you, moms are or were iron deficient during pregnancy, or if you're a baby was born preterm or with a low birth weight because this transfer of iron from mom to baby happens at the tail end of pregnancy. It makes sense that preemie babies who weren't in utero at the end of pregnancy, when that iron transfer was supposed to happen. Well, there's going to be at higher risk for iron deficiency for my quadruplets, they were born at six weeks premature at 34 weeks gestation. So part of their NICU protocol was as it is with all premature babies monitoring their iron status and then supplementing as needed. The important thing here is we're testing and following supplement regimens as recommended by a credentialed healthcare provider, right?

Katie Ferraro (6m 41s):

We were working with the pediatric dietician in tandem with the neonatologist, the other NICU nurses. We don't self-diagnose nutrient deficiencies or it gives supplement's to babies if there not needed because iron as with many other mineral supplements can very easily be toxic. If dosed in properly, actually iron toxicity is the leading cause of poisoning in children because there are those gummy vitamins, right? The older kids or candy they get in to them. They eat a lot of iron, not good. So even tho iron is like an over the counter supplement that you all can go down to the Walgreen's are the drug store and buy, without a prescription or you just don't want to go messing around with supplementing iron Willy nilly for small children, this is serious stuff. And so all this talk of iron, like what is it as a mineral?

Katie Ferraro (7m 22s):

What does it do? It's found naturally in foods can be added to foods through the process of enrichment or fortification. And iron is important because it's how our bodies transfer oxygen around the body. And in babies, iron is very important for their neuro development and their growth. Now I mentioned that it's a mineral and it's found naturally in foods, but where does iron in our foods come from? And maybe you've heard there's two types of iron there's heme iron and non-heme iron. So heme iron comes from animal foods. Heme iron is better absorbed by the body than it is non-heme iron. And non-heme iron is found in plant foods. Well, not as well absorbed there or some plant foods, they can still provide appreciable amounts of iron in the babies diet, especially for vegetarian or vegan babies who may eat little or no animal foods.

Katie Ferraro (8m 7s):

And then now that we know the iron is well, how much iron does my baby need? And this is where a lot of parents tend to freak out. They'll read a blog or Instagram post that says the current recommended dietary allowance. The RDA for iron for baby seven to 12 months is 11 milligrams of iron per day. And then they look around and to read some label's, which by the way, most foods have no more than one milligram of iron in a serving size. And then there's baby starting baby led weaning and is typical. And to be expected that baby's not eating very much, right? Because there are still learning how to eat. So then the parents will panic like, oh my Gosh, there was no way my baby is eating 11 different one milligram iron foods per day. They're not even close to eating what that posted serving sizes. So they are eating even less iron than I think.

Katie Ferraro (8m 50s):

There is no way that these real foods, it can meet my baby's iron needs and they give up on baby led weaning, and they go buy iron fortified, white rice cereal and start shoving in the baby's mouth, on a spoon. But here's the deal. The early part of baby led weaning is when your baby is practicing, learning how to eat, just like we don't want to freak out about counting calories during the first few weeks or months of baby led weaning. And I should point out we never want to be counting calories for children, but I'm always encouraging you guys to focus on how your baby learns to eat and giving them time to practice those skills and stop stressing out about how much they eat. The same goes for iron. Because, when we look at that RDA for seven to 12 month old babies, it was calculated on the assumption that babies eat very low amounts of meat because traditionally they do, but here's the other deal.

Katie Ferraro (9m 35s):

Babies can learn to eat meat early on in baby led weaning and they can do it safely. And meat happens to be a very valuable source of iron. So if your family does eat animal foods, I would encourage you to get in the habit of offering meats to your baby early and often it's important for a taste and texture standpoint, but of course, it's also important for nutrition in order to provide iron and zinc and other valuable nutrients. So don't be scared of those animal foods. If you guys eat them in your family already, your baby can learn to eat them. So a little bit more about which foods have iron. Again, if you're eating animal foods and your family get focused on, including those, even in the earliest weeks of baby led weaning.

Katie Ferraro (10m 16s):

Week one, I know early on your babies, not actually eating very much, but learning how to eat these types of foods is an important precursor to actually be able to get enough nutrition from them. So when you're baby six to seven months of age, we like to see, or a baby eating one to two times per day. If you're following my five step feeding framework, we're introducing five new foods per week. Now once you're a few days in and you start offering two to three foods per meal, and you're doing that one to two times per day, you just want to make sure that at least one of the foods that your offering on the plate has one milligram of iron or more, that's a really good rule of thumb to get started with.

Katie Ferraro (10m 56s):

You don't go to 11 milligrams of iron from fruit right off the bat. That's impossible. I can barely eat 11 milligrams of iron for food as an adult. But this habit of doing one milligram iron foods, once a meal is a good practice for two reasons. First, it gets you in the habit of reading nutrition labels and recognizing which foods contain iron naturally. Oh, we were going to introduce soy today. I'm going to do tofu. I'm looking at the label. Wow. Tofu has a lot of iron in it. You're killing two birds with one stone here, right? Not only are you introducing your baby to and allergenic food proteins like soy, but you also giving them iron. So secondly, the other important thing is that this practice starts priming your baby's ability to be able to successfully eat these foods.

Katie Ferraro (11m 38s):

You baby, can't learn to eat foods that they're not being offered, right? So it's on us. We're following the division of responsibility and feeding theory that Ellyn Satter teaches us about. We're in charge of what the baby eats. We're also in charge of where they eat and when they eat. But the what stuff we got to be choosing high iron foods, the heme iron foods that I mentioned before, that's the type of iron that comes in animal foods. High heme iron food foods are foods and Babies can eat these like meat and poultry. So we're talking beef and lamb and pork and chicken and turkey and certain types of fish and shellfish and egg yolk is also another valuable source of heme iron. Now non-heme iron foods, are things like lentils and legumes, which are dried beans and tofu and safely prepared nut and seed foods, if you guys have my hundred first foods list.

Katie Ferraro (12m 26s):

I'm actually going to provide in additional lists on the show notes page for this episode, that I'm going to list out which of the food's on the hundred first food left have one milligram or more of iron per serving. So you can start organizing the sequence of the foods that you introduce. Again, I don't wanna drive you crazy. I don't want to make you neurotic, but I also don't want you to feed like all the low iron foods early on and then be like, oh shoot, my baby. Doesn't know how to eat iron foods. So you can find that list of the high iron foods from my a hundred first foods list. If you go to the show notes page for this episode and that's going BLWpodcast.com/ 137. And if you don't have my hundred first foods list, yet you can grab that for free. I give it away to everyone on my weekly online workshop called BABY LED WEANING FOR BEGINNERS.

Katie Ferraro (13m 8s):

This workshop is all about how to get your baby to eat 100 different foods before turning one, without you having to spoonfeed purees or buy pouches, you can sign up for this week's workshop times. I'll linked to the signup page again, in the show notes for this episode, BLWpodcast.com/137. So how can we ensure that our baby is getting enough iron from the baby Led Weaning Foods that we're eating? Eating iron foods is one thing, but having your baby's body absorbed them is another. I did the whole podcast episode dedicated to increasing iron absorption. If you want to listen to that, it's called three easy ways to boost your baby's iron absorption and that's episode number 21. I'll link to it on the show notes again, for this episode, BLWpodcast.com/137, and I also recently interviewed the founder and CEO of the lucky iron fish company.

Katie Ferraro (13m 56s):

It's just a really unique product. It's an iron ingot that when you cooked foods within it, it actually increases the iron content of those foods. So that was episode 104 and it was called how the lucky iron fish can increase iron absorption. And that was what their founder and CEO Gavin Armstrong. So the most important thing you can do, just high-level, to increase your baby's iron absorption from the other foods that are offering is to offer vitamin C rich foods alongside the iron food. So fruits and vegetables have vitamin C. If you're following my five-step feeding framework, we introduced one new fruit, two or a baby each week, we introduced one new along with the other three food groups, basically your covering your vitamin C basis there and real quick, I just want to touch on what the research says surrounding iron intake and absorption in babies who do baby led weaning.

Katie Ferraro (14m 40s):

And there are some families that have hesitations about doing baby led weaning. And they'll say, oh, I have to do rice cereal or baby cereal to make sure my baby's getting enough iron. And you don't! I need you to know that there is no data to suggest that babies who start solid foods with baby led weaning have lower iron status than traditionally spoonfed babies. That's just the truth. People think that they need the iron fortified cereals, but they don't. In fact, if you look at the BLIS trials studies, BLIS stands for a Baby Led Introduction of Solids. That's the studies where one group of babies did baby led weaning plus had additional training on reducing choking and offering nutrient rich foods. And when they compared the BLIS group to the straight BLW group who are just like, try to figure it out themselves, but didn't have extra education.

Katie Ferraro (15m 22s):

The BLIS group had a higher introduction of iron containing foods in the first week of the introduction of solids and offered more portions of such high iron foods at six months. And the reason why it was because that BLIS group was educated and instructed to begin offering iron rich foods in the first week of starting solids, you can be that BLIS group. You can, you don't just have to do fruits and vegetables by themselves, right? Those foods are fine, but they don't have iron in them. You shouldn't just be offering those foods. Babies need to be eating iron rich foods early and often. So again, if you're hearing this, when you're just starting out, just get in that habit of doing the iron rich foods in week one. And so to summarize the research about iron and baby led weaning quote, "a baby led approach to complimentary feeding does not appear to increase the risk of iron deficiency in infants, when their parents are given advice to offer high iron foods with each meal, end quote.

Katie Ferraro (16m 19s):

So this is my suggestion. Consider this episode your advice to be offering high iron foods with each meal. I'll go ahead and link to the research studies about iron and baby led weaning in the show notes for this episode, BLW podcast.com/137. And if you're kind of a research nerd are you wanting to learn more about the nutrient and nutrition research behind baby led weaning, please do check out the episode that I did with Dr. Amy Brown. It's called the Evidence Behind Baby Led Weaning with Amy Brown PhD. That's episode number 70. Amy Brown is the preeminent baby led weaning researcher. She has so many great pearls of wisdom in this interview. She's summarizing all the research that supports baby-led weaning as a very viable, safe, and even preferable alternative to traditional spoon-feeding.

Katie Ferraro (17m 1s):

So I hope you guys enjoyed that little rundown, all about iron and why your baby can get enough iron from baby led weaning foods. I hope you are inspired and confident to feed your baby these iron rich foods. You do not have to do iron-fortified rice cereal. You don't need to, because you're a baby can start learning to eat high iron foods early on in the weaning process. If you want to grab that list of foods from my a hundred first foods list that I'll have one milligram iron or more per serving, just go to the show notes for this episode, it's at BLWpodcast.com/137. And if you still haven't gotten my a hundred first foods list, that's available to everyone on my free weekly workshop called BABY LED WEANING FOR BEGINNERS.

Katie Ferraro (17m 42s):

That workshop is all about how to get your baby to eat 100 foods before turning one, without you having to spoon feed purees or buy pouches. Everyone in the workshop gets a copy of my hundred first foods. So you'll never wonder which foods to feed your baby. And then if you want to get kind of more organized, you can even start organizing what high iron foods you'll be introducing day by day to ensure that your baby is eating these foods early and often. Thanks so much for listening guys and I'll catch the next time. Bye now!