Which statement about iron needs for exclusively breastfed infants is correct?

Which statement about iron needs for exclusively breastfed infants is correct?

• A. They require iron supplementation starting at 4-6 months
• B. They do not require iron supplementation
• C. They require supplementation starting at 12 months
• D. They get iron only from solid foods

Answer: (A)

The key idea is that iron needs in a term, exclusively breastfed infant rise after about the first 4–6 months. Although breast milk provides highly bioavailable iron, the total amount is small, and the infant’s iron stores from birth start to run down around 4–6 months. To prevent iron deficiency, these infants should begin a daily iron supplement starting at about 4–6 months (roughly 1 mg/kg of elemental iron per day) until they start consuming enough iron-rich solid foods or iron-fortified formula. Waiting until 12 months misses the critical window and increases the risk of iron deficiency. Solid foods alone cannot supply sufficient iron in the early months, so supplementation isn’t about relying on solids first. This is why starting supplementation at 4–6 months is the recommended approach.

The key idea is that iron needs in a term, exclusively breastfed infant rise after about the first 4–6 months. Although breast milk provides highly bioavailable iron, the total amount is small, and the infant’s iron stores from birth start to run down around 4–6 months. To prevent iron deficiency, these infants should begin a daily iron supplement starting at about 4–6 months (roughly 1 mg/kg of elemental iron per day) until they start consuming enough iron-rich solid foods or iron-fortified formula. Waiting until 12 months misses the critical window and increases the risk of iron deficiency. Solid foods alone cannot supply sufficient iron in the early months, so supplementation isn’t about relying on solids first. This is why starting supplementation at 4–6 months is the recommended approach.