Thursday, September 25, 2008

Iron Deficiency in Infants

I’ve been thinking a lot about iron lately. At River’s 9-month check-up, his hemoglobin level was a little under the desired levels (10.7 vs. 11-13). The doctor suggested we give him fortified cereal twice a day and get some liquid vitamins with iron.

“Can’t I just give him some more meat?” I asked, a couple of times before the doctor acknowledged that giving him meat would help too.

River has had a largely vegetable diet to date because we feed him what we have and this summer, we have had a bounty of vegetables. He’s eaten all the veggies, including iron-rich ones like kale and broccoli. He also usually eats fortified cereal for breakfast (I’m giving it to him until we run out, then I’ll switch to non-baby food). And he drinks 2-3 bottles of iron-containing formula a day.

I looked online to see which foods contain a lot of iron. Meats, beans and greens led the list. I resolved to try to get more meat into his diet. And I would skip the vitamin drops. It just seemed wrong to me, given the bounteous and healthy diet that he eats, to think that I need to purchase a special product for him to meet his nutritional needs. What is wrong with nature if he can’t get it from his food? Or what is wrong with the guidelines?

Then I read about the importance of iron in the development of brain function and cognitive skills. I read that if levels are too low early on that the developmental delays couldn’t be made up. I could damage him for life. I began to worry, seriously, if it was a mistake to not get him the drops.

A few days later, a discussion began on the online parenting group I belong to. It turned out that a lot of the parents on that list were told their babies iron levels were low – especially those that were breastfeeding more than six months. They wrote about how the iron stores a baby is born with start to deplete around six months and how the levels of iron in breastmilk are low. They were told to use the drops too. Some did and others did it only sporadically and their kids still reached the desired hemoglobin levels in time.

Then the discussion turned to evolution and why should iron levels be low if a baby is breastfeeding and why should that be a problem if this what evolution provided. They talked about the negative effects of iron – how bacteria need iron to latch on to and that perhaps lower levels of iron reduce a baby’s susceptibility to disease.

At least two people recommended the book The Survival of the Sickest by Sharon Moalem. I got the audio version and began listening to it immediately. One thing I learned early on in the book is that breastmilk contains lactopheron, a protein that combines with iron, preventing bacteria from feeding on it. At the time when I’m starting to doubt how useful it is to keep breastfeeding, that in itself made me think it’s worth giving River at least some breastmilk for as long as I can.

The book describes the author as a “maverick scientist.” I think it sounds like just the book for me and I can’t wait to finish it. This guy is finishing his MD and has a Ph.D. in human physiology and neurogenetics/evolutional science.

I’m not so into fringe theories. I want to see scientific evidence to back up hypotheses. But I also feel that the medical establishment doesn’t welcome a lot of questioning, especially questions that drive down profits in the industry. An intelligent, thoughtful person who shows evidence but is willing to go against the grain is someone I’m very interested in listening to.
In the meantime, I temporarily feel better about going with my instincts and skipping the drops. I made River scrambled egg yolks for breakfast, and a fantastic spaghetti squash with lots of meat sauce for lunch. I think he will be just fine.

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