Should You Feed Your Baby Iron Fortified Food? (Part 2)

This is the second part of a two part series written by Dr. Cate Shanahan. If you missed Part 1 of this series, go read it first.

Most pediatricians advise breastfeeding moms to supplement their baby’s iron intake with drops. And when its time for baby to start on solids, the current recommendation is to chose iron-fortified cereals after 6 months of age and to continue that supplementation until around age 2.

But, if you’ve read part one, you know that there is enough evidence that this might be a really bad idea to make me change the way I practice. It turns out that we have research to show that a seemingly modest excess of iron can be bad for everyone, and especially for children.

Why would this be?

As with so many nutrients, it’s all a matter of balance.

We need a steady supply of iron because only iron can complex [associate without binding] with heme proteins in our blood to absorb oxygen in our lungs and then release oxygen wherever its needed. Iron is also necessary for many metabolic functions because of its unique reactions with oxygen. But with too much iron, the oxygenation reactions can run out of control, releasing free radicals that effectively burn us from the inside out.

While doing the the research for Deep Nutrition, I learned that the underlying pathology behind so many illnesses is uncontrolled oxidation. Oxidation reactions can go out of control in any tissue. And depending on exactly what they damage (cell membranes, enzymes, DNA), a variety of diseases can result. With this understanding, I now appreciate how iron-induced oxidation in various parts of a growing baby’s body can lead to each of these five serious health problems.

  • Lowered intelligence: In the nervous system, iron and oxygen react with certain fatty acids in nerve cell membranes. This can not only damage the affected nerve cell but also trigger inflammation and repair mechanisms that can lead to headaches and cause blood clots and swelling that can extend to nearby tissues, disrupting brain function. If these reactions are going on every day that the baby gets that extra iron, untold millions of nerve cells may die, and those that remain may be forced to jerry-rig novel connections that may cause abnormal behavior.
  • Bacterial infection: Bad bacteria love iron. Iron in the gut can promote the growth of pathogenic bacteria. Only 5% of the iron is absorbed from the gut when the source is fortified cereals, compared to 50% of the iron being absorbed from breastmilk. This leaves an abnormally high amount of unabsorbed iron in the gut to promote the growth of pathogens that cause intestinal and even blood infection, and disrupt immune function for some time after the infection is gone.
  • Early Atherosclerosis: Iron and oxygen react with certain fatty acids in fat-carrying blood particles called lipoproteins (the L in HDL and LDL cholesterol). The reaction damages the particles so that they can’t be recognized by the body. The unfamiliar particles never bind to the docking sites on that allow lipoproteins to unload their nutrient cargo (nutrients like phospholipids, vitamins A, D, E, and K, and more). Instead of nourishing you, the damaged particles float endlessly in your bloodstream like plastic bags in the Pacific ocean. Eventually, they glom up together and precipitate out of circulation to form the beginnings of atherosclerosis called fatty streaks.
  • Cancer: Iron and oxygen react with a wide variety of chemicals in the cell nucleus to generate dangerous free radicals. Free radicals are high energy particles that, like X-Rays, can damage DNA. DNA mutations place us at high risk of developing cells that behave selfishly, and will divide and grow in spite of signals that they need to stop. This is how DNA damage leads to cancer.
  • Stunted growth: I’m not sure there’s a single mechanism that explains how excess iron leads to body-wide skeletal growth delays, including the skull and long bones. It may be that all this disruption burns up valuable nutrients that may no longer be able to support normal skeletal growth.

Because of the growing evidence that iron-fortification in babies is not without risks, increasing numbers of pediatricians are choosing to forgo the American Academy of Pediatricians recommendation to supplement babies with additional iron beginning at age four months and, rather, test iron levels in babies before deciding whether or not any iron supplementation is indeed appropriate.

To me, these research findings confirm my feelings about commercial baby formulas and cereals. The fact is, these processed products cannot begin to compete with mom’s breast milk to give baby a running start for a life of extraordinary health. And when baby’s old enough for solid foods, there are far better alternatives than a box of cereal.

If you’ve been feeding iron fortified cereals to your toddler, here’s a few steps you can take to benefit your toddler’s health starting today:

(photo by nofi, diagram by dr. cate)


  1. RPL says

    Well written. It is crazy to think that young children need anything but what they were designed for- mother’s milk. I cringe at all the crazy ideas out there right now, even recently in WAPF friendly sites- ugh. Formula is formula, plain and simple. If the young were meant to digest food first hand, they’d be born with teeth. I shudder to think what would have happened to my GAPS babies if I had given them anything but my milk- how dangerous a notion.
    I mourn for the loss of the baby that just perished from the bad formula (sold at a wal-mart?) what a tragic loss.

  2. Krissy says

    What are your thoughts on the iron contained in all prenatal vitamins, would this contribute too much iron for the baby through breast milk?

  3. says

    It is always hard to know what to do with information like this. Maybe a compromise of sorts by giving a partial iron supplement to the babies?

  4. spelling/grammar freak says

    Hi, don’t know if anyone’s noticed, but in your “Get More Updates” graphic it says Food Renedgade instead of Renegade. Not trying to be a jerk, I would want someone to tell me if I had typos so I am just pointing it out.

    Just found your blog and it is very inspiring…will be coming back for more!

    • KristenM says

      Ha! Thanks for catching that. I just had that designed and put up before Christmas and didn’t notice the typo. I’ll be sure to have my designer fix it.

  5. says

    Nina Planck’s book looks great! I’m going to have to get it! With my first child I tried that baby cereal and thought it was disgusting! If I couldn’t stomach it, why did I expect her to like it? So, I stopped giving it to her and gave her real food instead.

    Avocados, root vegetables, bananas…these have been the first foods for the rest of my children. (I have seven.) I’m proud to say that I have never bought a jar of baby food in my life!

  6. Kristin says

    I went the traditional “mush” route with my first and the found Baby-Led Weaning, which encourages the same things as Nina Plank. My DD is a picky eater (oldest), my so will at least try things, even if he doesn’t end up liking it. My newborn DD will get only real food as well.

    One question: where do you find formula that isn’t iron fortified? I had o supplement DD#1 and DS after 4 months (DD was FTT, son’s weight flatlined between 2 and 4 mos., DD#2 is havng trouble gaining as well, she’s 1 month old). I am working to increase my supply once again, but I’d like a backup to consider, if it becomes necessary (I hope it doesn’t, though).

    I will be taking this article to my kids’ pediatrician when DD#2 has her 2 month check-up.
    Thank you!

  7. Crystal Mann says

    I am currently doing a research paper in an undergraduate psychology class on ADHD. I stumbled across an interesting article and immediately thought about this blog post (which I read several weeks ago) when I read this line in the abstract: “The present study found that 58 subjects with ADHD (average age 8.5 years) had significantly higher intakes of iron and vitamin C compared to those of 52 control subjects…”

    Here’s the article info if you’re not familiar with it already:

    Dietary patterns and blood fatty acid composition in children with attention-deficit hyperactivity disorder in Taiwan

    Journal of Nutritional Biochemistry 15 (2004) 467–472

    Jiun-Rong Chena, Shiou-Fung Hsua, Cheng-Dien Hsub, Lih-Hsueh Hwangc, Suh-Ching Yanga

  8. Lainey says

    Hi! Thanks for the advice. My baby was born early (at 34 weeks). Would you still recommend getting iron levels checked before going ahead with the supplement and fortified foods?

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