Iron deficiency anaemia is one of the most common deficiencies we see in children in the UK, and it is a common reason a child gets referred to a dietitian, normally in one of the community based clinics.

It is also very manageable through the weaning diet, which is why it is worth understanding properly.

Why babies start with a good supply

At birth, babies have a good supply of iron, as long as they are born at term and their mother had a good supply during pregnancy.

Delayed cord clamping, which you may remember from birth, is essentially about transferring as much iron as possible to the baby.

Those stores run low by around 6 months of age.

The requirement jumps sharply

Iron requirements between 7 and 12 months of age jump massively, by around 45 percent.

That is a significant increase over a short period, and it happens exactly when the stores your baby was born with are running out. This is why iron rich foods at this stage are so important, and why solids from around 6 months are doing genuine nutritional work rather than just being practice.

Where to find iron

Iron is present in many of the foods we already eat.

• Red meat, which includes beef, pork and lamb.
• Offal, such as liver. Liver should only be offered to babies a maximum of once a week, as it is very high in vitamin A.
• Poultry, which contains some iron.
• Fish.
• Pulses, nuts and seeds.
• Dark green vegetables such as broccoli and kale.

If a child's diet does not contain enough of these foods, they can develop an iron deficiency.

Haem and non-haem iron

You may hear these terms. Haem iron is the iron found in red meat, and it is the most readily absorbed by the body. Non-haem iron is the iron in plant based sources.

This matters practically, because it means plant sources need a bit more help to be absorbed well. Vitamin C rich foods, such as certain fruits, help with that absorption. Serving a vitamin C rich food alongside an iron rich food is genuinely worth doing, especially where the iron is coming from a plant source.

We look carefully at the V&Me menus to make sure this combination is there, so absorption is maximised rather than left to chance.

Why too much milk causes a problem

Deficiency can also happen when the body does not absorb the iron from the foods being eaten. One of the most common causes of this is a child drinking a lot of milk, because milk blocks iron absorption.

So a baby having very large volumes of milk can be eating reasonably well and still end up short on iron.

Fortified foods

Alongside the foods above, iron is added to a number of products.

• Certain milks.
• Certain breads. All bread in the UK is fortified with iron and calcium apart from wholemeal bread, and some have a particularly good amount.
• Certain breakfast cereals, though for under ones we would only recommend the low sugar varieties.
• Some baby formula milks.

What a day meeting the requirement looks like

Children can meet their iron requirement fairly straightforwardly. With three milk feeds a day, whether breast milk or formula, some iron is already coming in. The rest comes from food.

As an example across a day:

• A fortified breakfast cereal in the morning.
• Some egg with fortified bread at lunchtime.
• Something like soft meatballs, or a finger of fish, with some broccoli in the evening.
• A vitamin C rich fruit served alongside.

That would quite easily meet their iron intake.

Vegetarian and vegan diets

It can be a bit more tricky to meet iron requirements if your child is having a vegetarian or vegan diet. It is certainly possible, but it may need a bit more support.

If that applies to you, it is worth getting proper advice rather than working it out alone.

Further reading

The British Dietetic Association has a fact sheet on iron if you want more detail than this.