A mom of a thriving, exclusively bf 8 week old, born full term, called me
today.  Her ped said at her 2-mo well baby check that baby's lips look pale,
wanted to give iron drops.   Mom (who has read a thing or two) hesitated, so
ped gave a slip to have a blood test.  Told her that "above 35 is fine, 33 or
34 is borderline, below 33 is definitely anemic" and the baby really would
need supplementation.  Mom called me to ask whether this is correct.

I, ignorant of the answer, went to the books.  All of course told me that
very few bf babies need supplementation.  But in fairness the doc seems not
to have said that all need -- he thought his baby's lips looked pale.  Babe's
only 2 months, so stored iron is still going down and presumably if it's a
little low now it will be lower in another month or two, yes?  Mom states she
was anemic in pregnancy -- will baby have lower iron stores because of that,
do we know?

Second, the books (Auerbach & Riordan, BAB) say that normal hematocrit at 3
mos is around 12 gm/dl.  Can anyone tell me what measurements the doc is
using (33 what?) and how it compares?

Finally, given the problems of supplementation (poor absorption,
constipation, ties up the lactoferrin etc),  how far below normal iron scores
nonetheless warrant giving the baby drops after all?

Elisheva Urbas
lay bf supporter, longing for the day when NY mothers can be confident that
their pediatrician is at least as knowledgeable about infant feeding as, say,
me.

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