Upset about weaning and iron

[ironic]

I feel like I’ve got everything wrong. DS was 5 weeks early and hospital told me to ask GP to prescribe iron supplement. When I got home, GP and health visitor said there was no need for this which I accepted.
He is now 27 weeks, having been EBF until now, and I started weaning just over a week ago... but he is refusing all puréed or lumpy spoon food and BLW chunks. He spits out everything from a spoon and does not have the coordination for chunks yet. I would be more relaxed about this if Annabel Karmel book and others hadn’t sent me into panic about depleting iron levels, how it’s essential for normal cognitive development. I’m so upset that he may not be getting what he needs even though it is early days and blame myself for not listening to what the hospital said he needed. How can I get him to eat more iron rich food like beef or spinach when he won’t even take apple or baby rice?

I worried a lot about this too. I started giving a vitamin supplement, I used WellBaby from Boots which has 4mg of iron in it. It tastes very sweet so he is unlikely to refuse it, in any case you can also mix it with milk.
If there is any cause for you to genuinely think he is lacking iron (is he very pale, gets tired quickly or is his development delayed?), go back to the GP to have him checked.

By the way, it's normal for babies not to take to weaning straight away. Some babies take a while to start enjoying solid food. Try not to get too anxious about mealtimes because your baby will pick up on it. DS1 wasn't interested in solid food apart from fruit and pasta until he was over a year old, and seeing as he had had iron deficiency as a baby I understand how stressful it is. I hated mealtimes because he hardly ate anything and I was so worried. Try to stay positive, everyone starts eating solids sooner or later!

I wouldn't worry, but if you want to DO something to make yourself not worry there are plenty of children's multivitamins etc you could try, just use a medicine syringe.

Alternatively infant formula is fortified with iron, you could try offering it as a drink or mashed into food /cereal.

Early weaning can be really slow progress, but he will get there.

Baby food is just additional till one year. It’s not vital. Milk has everything. Introducing food is more about introducing him to different tastes and textures not nutrition. At this stage anyway. Mine ate very little till 10 months and a year. All very healthy children. You need to be careful not to overly obsess about calories and food intake as it will have a negative effect on your child long term. Best be led by your child’s appetite with how much they want to eat. Keep trying different foods so that the have a wide repertoire of tastes.

it's normal for babies to take a while to learn to eat. just keep offering.

unfortunately it's also normal for hv&gp to be dismissive...
do you have anything in writing from the consultant about the iron?

tbh I would get a supplement for babies with iron. baby needs vit d3 as well.

good luck!

Why would he need a supplement? Five weeks early is not much. And he'll be getting iron from milk. Nor does he need vitamin D after the summer we've had!

We're a robust species who can get everything we need from our diets, the supplements industry exists to make money.

For what's it worth, my two never had supplements. They are 4 and 8, extremely tall and extremely bright. I am a vegetarian and I didn't even supplement iron in pregnancy- my iron levels were fine.

At 22 weeks corrected, his tongue thrust reflex is probably still quite strong and hence why you're having issues with lumps. I BLW my DC but not until 6-7 months. Younger DC was closer to 8 months before they really took to solid food.
I understand that early weaning is advised for prem babies as they have less stored before birth, so maybe try smoother purées for a few weeks. Regarding the iron, you can get supplements for piece of mind, like this one (you can get it in Boots / supermarkets):

www.vitabiotics.com/wellbaby/multi-vitamin-liquid

I wouldn't worry as someone else said, milk should be there main source up until 1.
Since he was 5 weeks early , you could leave weaning for another 2/3 weeks and continue with the milk.
Then start again slowly.
In the mean time you could give him the utensils to play with - spoon , bowl etc abs do lots of eating in front of him.

I weaned my 33 weeker at 26 weeks a couple of months ago. Initially I had to feed him in the bouncer as he couldn't sit in the highchair and started with baby porridge and gradually moved on to purée sand thicker chunks. It was hard at the beginning but he's 8 months now and loves his food. He can finally feed himself stuff although this has only come on in the last couple of weeks.
I wouldn't worry too much above it the iron, we were prescribed it from hospital and given a set dose. The pharmacist queried why the dose wasn't increasing as he grew but that's just what they do here. We've stopped it now anyway as the consultant said we could once he was weaned.

kellymom.com/nutrition/vitamins/iron/#uncommon

Carry on BFing as he will get iron from you ensure your own diet is iron rich. Let him take his time weaning and take the pressure off.

Nor does he need vitamin D after the summer we've had!
He does need vitamin D, as babies shouldn't be exposed to direct sunlight, and it is only through direct, prolonged exposure to sunlight that enough vitamin D is produced.

I also worried about this as mine were also EBF. Whereas formula has added vitamins like iron and D3. I as PP mentioned gave them the well baby multi vitamin drops. Which they loved as it was sweet. It just relaxed me abit as like you I felt like it took a while for them to eat anything.
Try not to worry about food intake too much the first few weeks my DD barely ate anything. She never really seem to like anything unless it had banana in it. From about 7 months I moved onto blw. Again most things do just get throw everywhere at first. It's from about 9/10 months that most babies start to properly eat. It's your job to offer the food the rest is up to your baby.

I would've thought they get all they need from milk. I'm ebf my 4 month old but I've always suffered from anemia and have felt my iron levels dropping recently probably because of a combination of 8 wks pp bleeding, bf and then I got the mirena coil and I'm still bleeding from that! So I'm taking some breastfeeding vitamins that have more than the recommended daily intake of iron. If you're still breastfeeding maybe you could take an iron supplement? And I've not been giving my Lo vit D because she's been in the sun a lot (not direct sunlight) and that's enough.

because she's been in the sun a lot (not direct sunlight) and that's enough.
Please don't perpetuate this myth. Indirect sunlight is not enough to produce a sufficient amount of vitamin D. Bf babies do need vitamin D supplements.
Rickets used to be extremely common, so much so that people have still heard of the disease a hundred years after the last cases. It has not magically disappeared, it is down to vitamin supplementation which began with cod liver oil.

Thanks for your advice everyone- lots of sound suggestions/reassurance. I’m doing the vitamin drops now which also get spat out but I figure a bit must make its way down. And trying to relax about the volume as some has definitely come out the other end....

@BestBeforeYesterday of course babies can be exposed to direct sunlight! Just not hours of the stuff. What is it you think will happen if a baby goes in the sun for short periods?

Mmm OP despite what everyone is saying, I think your baby maybe does need a supplement.

My DTs are almost exactly in the same position - 26w and were 5 w early - they are under consultant care and must have iron every day till 1 year old. They get Sytron which is v sweet.

Can you go back to the hospital?

Baby food is just additional till one year. It’s not vital. Milk has everything.

This is wrong. Breastmilk doesn't have enough iron or vitamin D and first stage formula doesn't have enough iron. Not a huge deal for the first few months, as we're born with enough iron for the first six or so. But the milk itself isn't sufficient once we get through that. People think that because the iron in breastmilk is very easily absorbed that's fine, but that's a different issue to whether there's enough of it in the first place.

That said, under ordinary circumstances a 27 week old would be unlikely to need supplementing. I do understand OPs worries though as she has a premie.

Breast milk certainly has enough iron, it is a unique form of iron that is easily absorbed by the baby. Formula milk has iron added, but it harder for the baby to absorb. Babies do not need a lot of iron. That is a myth peddled by formula milk companies to justify follow-on milk, which babies do not need. The NHS now recommends vitamin d supplements from birth and for all childen.

Breast milk has enough calories in it but not enough iron past 6 months see scienceofmom.com/2011/10/12/why-is-breast-milk-so-low-in-iron/ if you want the details.

I'd be tempted to go back the the doctor and check with them again - premature babies don't build up stores the way full term babies do.

Having said that, don't forget that most cereals are iron fortified. I don't know what foods you've tried but readybrek porridge is fortified and you can make it as runny or thick as needed.

Yep. There's that confusion of easily absorbed iron and sufficient iron again. They are not the same thing. Just because it's bioavailable, doesn't mean it's enough.