Should I Give My Toddler Iron Supplements?

Thoughts on iron supplements for babies/toddlers? My daughter had her iron levels tested at her 12-month appointment, and we were told that it was on the ‘low end’ of the acceptable spectrum and that we should start iron supplements.
—Anonymous

Most babies in the U.S. are screened for anemia between 9 and 12 months, even though there is a lot of debate over whether it is a good idea. That debate, I would guess, centers on a tradeoff between over diagnosis and underdiagnoses.

You’re falling into the over diagnosis end of the spectrum here. There are guidelines for treating anemia in kids — specifically, they define anemia as an iron level less than 11 grams per deciliter (g/dL). For good reason, these guidelines tend to be drawn conservatively.

It sounds like your child is not below this threshold. She isn’t anemic by the conservative standards. Her levels are acceptable. I’m not sure what the rationale, then, is for treating, other than the “more is better” approach — which, see above, isn’t clearly a good one.