Doctor says 9-month-old baby needs more table food
 
QUESTION: I just took my son for his 9 month check-up. We had someone filling in for our usual pediatrician. He did a test for anemia and said that his iron was too low. He also told me that the reason for this was that i was breastfeeding too much and that my son should be eating more table food than breast milk and baby food only when its more convenient. I never put pressure on my son to eat solids, though I offer baby food three times a day, so he doesn't eat much, and he loves to nurse. I am also giving him a multivitamin with iron, which he hates. Does he really need more food than milk at this young age?
Dear Michelle, No, John does not need more solid food than milk at 9 months. In fact there is a study quoted in La Leche League's "The Breastfeeding Answer Book" which showed that "breastfed babies not given iron supplements or iron-fortified cereal who were exclusively breastfed for seven months or longer had significantly higher hemogolobin levels at one and two years than breastfed babies who received solid foods earlier than seven months." (Pisacane, A. Iron Status in Breast-fed Infants. J Pediatr1995, 127(3):429-31. Did the doctor tell you what John's hemoglobin (iron) level was? Was it just low, or did he say he was anemic? For a child from 6 months to six years, the average hemoglobin level is 12, but normal ranges run from 10.5-14.0. If you feel more comfortable with your own pediatrician, why not call him/her back to discuss this. The other doctor may just not know much about breastfed babies! It could be that you could just add some iron-rich food into your baby's diet and check it again next month. Generally, the best source of iron is meat. Baby cereals have extra iron, but they are poorly absorbed. Was your baby already taking the multivitamin with iron, or have you just added that? Supplemental iron in a breastfed baby's diet interferes with his ability to use the iron from the breastmilk, so it may even be harmful. Most breastfeeding experts recommend letting the baby set the pace for solids, which it sounds like you are doing. There are many babies who aren't very interested in solids until after their first year. My own daughter really didn't eat much at all until she was about 14 months. Even then, her diet was mostly breastmilk. There are children who have been totally sustained on nothing but breastmilk for years because of rare metabolic disorders. Without breastmilk, they couldn't survive! Hopefully, your baby's iron level is only on the low side and will pick up as he gets older. If you have a supportive and knowledgeable pediatrician, he will work with you on this and want you to continue breastfeeding for at least a full year. (Now the recommendation of the American Academy of Pediatrics!) Hope this is helpful. It sounds to me like you're doing a great job! Cher Sealy RN, BSN, IBCLC, LLLL
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