The Health Ministry Recommends: Administer Iron to Infants Until They’re 18 Months Old

The Health Ministry recently updated its recommendations to include the administration of iron drops to infants until the age of 18 months, as opposed to the previously recommended 12 months.

Here’s why:

Iron-deficient anemia in infants is common in Israel, in comparison to in other developed countries. This could stem from Israelis’ preference for chicken products over beef products, or in light of the religious commandment to separate the consumption of dairy and meat meals by several hours, leading many to prefer eating dairy products.

The development of anemia in infants has instant ramifications and long-term risks to motor and cognitive development.

Studies show that an iron deficiency during infancy can influence children even at age 9, in the form of attention deficit disorders, or low cognitive functioning in comparison to their non-anemic peers.

In the short-term, anemia can cause weakness, tiredness, a decrease in appetite and, consequently, growth and motor development delays. As such, the Health Ministry recommends that all infants, without exception, receive iron supplements on a daily basis, from the age of 4 months.

Until recently, is was common practice to administer iron until 12 months of age, but the Health Ministry has amended its recommendations to members of the medical community to include administering iron until 18 months. It is now also recommended to move up infants’ routine blood testing to 9 months, instead of at one year.

How iron influences the prevalence of anemia in infants

• Daily administration of iron ensures your infant receives the iron they need to fill their iron stores. During their first year of life, infants develop rapidly, triple their weight and, therefore, need stores of available iron. Even a slight deficiency can influence their development.
• Studies found that administering iron across the board reduces the prevalence of anemia, especially if iron supplements are given in conjunction with an education on what constitutes an iron-rich diet, including: meat products, fish, eggs, legumes and green vegetables, together with foods rich in vitamin C, as they help with the body’s iron absorption capabilities.
• It is recommended that young infants be exclusively breastfed until the age of six months, as breastmilk is rich in iron - or to feed with iron-enriched formula. Exclusive breastfeeding after the age of six months can lead to anemia, which is why it is recommended to introduce solid foods from six months on.
  

How does giving the blood test earlier help prevent anemia?

Anemia is defined as a state in which there are less than 11 grams/deciliters of hemoglobin in the blood, among infants aged 6-35 months. But sometimes the hemoglobin levels are normal, even though the child is actually anemic. This is why the Mean Corpuscular Volume (MCV) count is also taken during the blood test. It measures the volume of the infant’s red blood cells. The Health Ministry stated that an MCV below 78 grams/deciliters likely indicates an iron deficiency, even if the hemoglobin levels are normal.

If, during the first blood test, one of those two measurements is abnormally low, your infant’s doctor will likely recommend a more general blood test, one that also measures Ferritin, another test that measures iron stores. A Ferritin score below 7 grams/deciliters also likely indicates anemia.

Diagnosing anemia on time via simple blood test will help the doctor prescribe the appropriate course of treatment, before any damage is caused to your infant.

Recommended iron dose for infants

• For preemies born before week 37 of gestation: 2 mg a day (1 drop), from one month, to 4 months.
• Infants over the age of 4 months: 7.5 mg a day (3 drops), until 6 months.
• Infants over the age of 6 months: 15 mg a day (6 drops), until 18 months.
  

How to choose iron drops for your infant

The Association of Doctors recommends using iron drops labeled as medication for the prevention of anemia, as opposed to those marked a nutritional supplements. Anti-anemia medications underwent clinical studies and were forced to prove their effectiveness in preventing anemia before receiving approval for mass marketing, as opposed to nutritional supplements, which do not need to prove their effectiveness.