In response to your concern about the validity of hemoglobin check at 1 year. 1. Hb at 1 year is only a screening test for anemia. 10.5gm/dl and above is what is considered nl in our textbooks. They do comment on the fact that iron in better absorbed from breastmilk than cow's milk and that BF babies need less dietary iron. 2. A low hemoglobin at 1 year does not necessarily mean that the child is Iron deficient. Other conditions such as lead poisoning can cause anemia as well and further testing is usually needed to make final diagnosis Iron deficiency is not necesarily nutritional. Chronic gi bleeding per example can lead to anemia even with adequate intake. 3. Babies most at risk for anemia 6 months and older and sometimes at earlier age are babies born with low iron stores. I think in particular of premature, small for gestational age, babies who had a bleeding problem at birth and therefore started off with a lower count. Small babies at birth, in addition to having low iron stores tend to grow faster to catch up with normally grown newborns and therefore may need more iron. These are your at risk category for nutritional anemia, in these children supplements may be appropriate at an earlier time. To answer your comment about how the children look, your typical "milk baby" develops and acts normally. They actually look pudgy and somewhat pale but otherwise they are very well adapted to the low levels of iron and continue to have normal activity. The classic example is the bottle fed baby 12-18 months drinking tons of milk in bottle and eating very little food. Good luck Maryelle