Look Closer: The First 24 Days of Your Child's Life About the Author Kristine Bell, RN Kristine Bell is a nurse who works on a medical-surgical unit at a Connecticut hospital. Kristine Bell, RN I love having a healthy baby. I always want to make sure she's healthy and happy. And I'm in the medical field, so I see my little boy with the most beautiful, healthy skin. Her healthy skin and my research that led me to the cause of his dark eye circles will appear on the pages of an upcoming book that I am writing about your baby's skin during the first year of life. Although Kristine, like most parents, noticed how dark her baby's eye shadow was during his first few months, the dark circles began to appear a few months ago. After he cried so hard one evening that she noticed that his cheeks were bruised, she began to think about how her baby's development might be affected by his dark eye circles. When she researched the cause of dark eye circles, she found it could be something as simple as insufficient iron in the baby's diet. She used her instinct to do what is best for her son and took her concerns to a pediatrician, who also told her it was nothing to worry about. At Kristine's seven-week appointment with her baby, the pediatrician mentioned that she was concerned about dark circles around her baby's eyes. The pediatrician pointed to a baby book on the side and said, "look at this. It says to try not to be stressed and rest, and not to be exposed to the sun or overwork yourself." She also suggested that Kristine feed her son breast milk if she was concerned. Although it was helpful for Kristine to hear the pediatrician talk about her concerns, it wasn't comforting for her. Kristine and her husband love being parents, and they want to provide the best possible environment for their son. It was heartbreaking for her to have to hear the pediatrician give such advice. That advice did not seem right for their little guy, and she wanted to know how her baby could fix the problem. Kristine didn't know how to go about figuring out what was causing her son's dark eye circles. She wanted to do what was best for her baby, and she did not want to make any negative changes to his lifestyle. Instead, she turned to her instincts. Kristine began researching dark eye circles and found information about the need for iron in babies. After reading a great deal about the importance of iron, Kristine started feeding her baby iron-rich foods. She told me that her dark eye circles have disappeared and she attributes that success to starting her son on iron-fortified cereals. The pediatrician had said to try to be rested, and Kristine is now aware of the effects that being a new mom can have on a tired body. After giving birth, many new mothers need to work more than ever. She is lucky that her partner's business was finally making enough income for the family. She is currently working less than her full-time job, but is concerned that she needs to start working less. At her first postpartum appointment, the pediatrician mentioned that Kristine had dark eye circles. But after she told me this story, I suggested that the pediatrician may have been mistaken. I know that dark eye circles can look like dark circles around the eyes, but they are a common side effect of sleep deprivation. Kristine had mentioned to her doctor that she was too tired to have a baby, and the baby had come too early. So I suggested to Kristine that she get in touch with her doctor and set up a prenatal appointment. She now has a follow-up appointment scheduled for next month, and I am hoping that they can figure out what is going on with her baby. I'm hopeful that Kristine will be able to continue to feed her baby iron-fortified cereals in the future, because she does not know if they are causing any damage to her baby's health. What Kristine and I both realized is that children need to develop a strong immune system before they are old enough to receive vaccinations. Without iron, the immune system cannot fight the viruses that attack them. Without sufficient vitamin A, the immune system cannot maintain itself. And without enough vitamin E, the immune system cannot work properly. Unfortunately, it takes a child years to fully develop an immune system, but you can help your child now by making sure your child is receiving enough iron, vitamin A, and vitamin E through good nutrition. The First Few Weeks Iron-Deficiency Anemia in Infants We need more iron than any other nutrient at this stage of a baby's development. During the first few weeks of life, babies can be given supplements of either iron or iron-fortified cereal. Iron is essential for building strong bones, and without it, your child will have low blood hemoglobin and a reduced blood volume. Babies cannot absorb iron from other sources until they are six to nine months old. While other children start with the Iron Kids Breakfast Cereal or the Iron Chef Cereal, these cereals can give your child more than 100 percent of their daily allowance of iron. If you have a baby who is older than six months or is not drinking milk, you can use foods high in iron, such as peas, sweet potatoes, chicken, turkey, and beef. Your pediatrician will be able to tell you the recommended serving sizes that you can use to make sure your baby is getting enough iron. Vitamin A Deficiency Vitamin A is one of the most important nutrients for developing vision and a healthy immune system, and you do not have to take a baby vitamin to make sure your child is receiving adequate vitamin A. Babies do not produce vitamin A on their own, but they can acquire it in foods like liver, carrots, and sweet potatoes. Vitamin A can also be added to formula milk. In the case of newborns who can't receive vitamin A, they should start with the Vitamin A/D/C Injectable for a child (with age restrictions). Make sure you keep your child from being exposed to UVA light for at least two weeks before and after giving this medication. You can keep your baby out of the sun for a week or so after they take the Vitamin A/D/C Injectable, but it's better to make sure they have the medication as long as possible. Vitamin E Vitamin E helps support your child's immune system and is important for developing healthy cell membranes and the prevention of cell damage, including those related to asthma, heart conditions, and eye problems. When pregnant, your baby needs more vitamin E than ever because their brain is developing rapidly and they have a higher risk for anemia. If your baby is born with low levels of vitamin E, a nurse or pediatrician will probably recommend giving vitamin E drops. In order for it to work properly, the pediatrician will have to know your baby's starting levels before recommending whether or not the child needs vitamin E. In addition to providing good nutrition, you can support your child's immune system by breastfeeding for a year and making sure your baby's skin and eyes stay moist by washing your hands often with a mild cleanser like the one found in Baby Magic. Make sure you avoid using lotions or creams, such as diaper creams, that contain petroleum by-products or other chemicals. Babies can get enough nutrients at this stage from breast milk or fortified cereals. When babies are born, babies will need a minimum of 20 milligrams of iron each day. In fact, newborns should be fed fortified cereal three to four times a day. If your child isn't being breastfed, a doctor's recommendation will be sufficient for a six-month-old. Breast milk will not be enough to meet the nutrient needs of most newborns and so, unless your baby is bottle-fed, you should be giving your baby a fortified cereal. Your pediatrician will be able to determine what you can add to your baby's diet to help her get what she needs. If she cannot breastfeed, which many mothers cannot do, she can have fortified cereal instead. It will ensure that her child is getting the needed vitamins and minerals. I recommend using one cup of cereal with breast milk and then one cup of fortified cereal at breakfast. If you are using a formula, use four ounces (ounces) of formula with six ounces of fortified cereal to get all of the nutrients you need. Babies who have dark circles and are not being breastfed can still get the iron and nutrients they need from fortified cereal, breast milk, or formula. What About Cereals? We live in a time when pediatricians recommend whole milk, organic foods, and fresh meats and vegetables, but at what cost? The majority of infants in this country, the United States, are on formula and do not breastfeed. In 2011, the government reported that 70 percent of babies were breastfed for the first two months of life and 32 percent for the first three months of life. Most pediatricians recommend that babies be fed iron-fortified cereals, but iron can do more harm than good. Iron overload has been linked to iron toxicity in infants. The iron in fortified cereal can cause excess iron to build up in the body, which can cause iron toxicity. The only way to know if your child is getting enough iron from fortified cereal is to check her hemoglobin. Checking hemoglobin in infants isn't always a good indicator, though. One study showed that children who were getting enough iron