Baby Led Weaning – To Prevent Iron Deficiency

Rice cereal as first food? It was an epic failure, not once but twice with my two girls.   One reason rice cereal is recommended as an appropriate first choice of food is because it is fortified with iron to prevent iron deficiency.

Iron is important for neurodevelopment.  In fact, Hare et al. published an article in Lancet, describing the neurological effects of iron supplementation in infancy has at least three critical windows:

  1. The preconception and in-utero period, when the fetus is dependent on maternal iron supplies that seed and support neurodevelopment
  2. The first 6 months of life, when iron is recycled from excess hemoglobin and is essential for myelin synthesis
  3. The following 6-24 months, when iron-depdent neurotransmitter pathways are established.

It is during this final critical window between 6-24 months in which parents are encouraged to introduce iron rich foods.

The authors also emphasize that while iron deficiency should be prevented, iron overexposure can lead to adverse health effects. Short term adverse health effects include nausea, vomiting and constipation.  In infants who have been fed with iron fortified infant cereal, the authors have found some observation that this can lead to increased pathological bacteria in the gastrointestinal tract.  They also claim that there is a potential link that iron overload may contribute to neurodegenerative diseases later in life.

As a pharmacist, I often see kids with iron deficiency requiring iron supplements.  Iron supplementation (or any medication) can be difficult to give to kids and can worsen pre-existing constipation. While I am not against treating with an iron supplement if clinically necessary, iron supplementation should not be seen as a first line option for an otherwise healthy infant,  Rather, consuming iron rich food is the preferred way to prevent iron-deficiency.

But what if you have a difficult time getting your kids to swallow a spoonful of the mushy rice cereal?

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Or that you would spend hours preparing other types of pureed food that would only take 5 seconds to end up on the floor, not to mention more time to clean up the mess afterward.

While introducing a pureed diet is safe and recommended for an infant who is ready to start solids,  it has personally created a lot of work for me with little results.

Lately, baby led weaning has become a popular way to introduce first foods in infants. Baby Led Weaning encourages infants to self feed with soft food with appropriate texture. I have never tried baby led weaning with my girls but I think I eventually adapted some parts of it (without realizing it) to maintain my sanity in the house. Then I start to wonder how other mothers from other parts of the world feed their infants if they do not have all the gadgets for processing or preparing pureed food?  It just seems so time consuming and impractical.

So I wonder in the context of preventing iron deficiency, baby led weaning may be more practical and effective. After all, a bite into a piece of boiled chicken leg will offer more iron than a spoonful of rice cereal that may or may not make into the infant’s little tummy.  In addition, iron from animals (heme iron) is better absorbed than plant sources of iron such as iron fortified infant cereals.

In the meantime, I have reached out to Allison Little, a registered dietitian based in Kingston ON who is also the founder of AllisonLittleNutrition.com. She offers monthly Baby Led Weaning Workshops to new moms who are interested to learn more about Baby Led Weaning.

I have also asked her to share her top 10 iron rich foods that are appropriate for baby led weaning:

  • Meatballs/meatloaf/mini burgers
  • Lentil patties
  • Tofu cut into sticks
  • Salmon
  • Eggs (scrambled, omelette, hardboiled)
  • French toast strips
  • Sardines
  • Omelette with spinach
  • Toast strips spread with black bean dip
  • Mini muffin made with blackstrap molasses

My girls are beyond the age for baby led weaning but I still find myself looking through these recipes as they are also easy finger foods that I can pack as an on-the-go nutritious snacks.  If you are interested to learn more about Baby Led Weaning, please check out Allison’s website here.

Thank you for reading my post. Note that I have no financial ties to Allison Little Nutrition.

 

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drugopinions

My name is Cynthia Leung and I am a practicing pharmacist in Kingston Ontario, Canada. This blog is for me to share my ideas, opinions and perspectives on how medications are used in our health care system. Note that these posts are my own opinions and do not represent the opinions of my current or former employers and / or organizations that I may belong to. Any possible case scenarios described in my posts would be modified to maintain patient confidentiality. This blog is not a platform for professional advise for patients or health care providers and the content is not meant to support any clinical decisions or replace professional opinions. Also the images are either taken or created by the author, or adapted with permission. I hope you will enjoy reading my posts!

One thought on “Baby Led Weaning – To Prevent Iron Deficiency”

  1. Largely retired from family practice, but looked after a lot of babes I delivered. perhaps you are using rice cereal as a representative of baby cereal, but there are also many alternatives. I always started with rice, as least allergenic, but oatmeal and other grains are on the market. Rice is more on the constipating side, so most of the children had a variety. Cereal has always been the first to be introduced because of iron content. Breast milk has some highly bio available iron, but often not enough. Most pediatricians will recommend iron supplemented formula in non-breast fed infants. The problem of gi effects of these formulae seem to be minimal.
    The most severe iron deficient children are those who consistently refuse solids and subsist on non iron containing milk or formula.
    Prematurity is another risk factor and often these children will be iron supplemented.
    Iron deficiency is not simply low blood and associated palour and lethargy, but linked with diminished intellectual development.
    While talking about infant feeding, the evidence is overwhelming that our fear of early introduction of certain foods, eg peanuts, egg, fish etc has been misplaced. Food allergies in children (for the most part) are reduced enormously by early introduction of these formerly forbidden foods.

    Like

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