At what age can a healthy infant begin Enfamil Poly‑Vi‑Sol (liquid multivitamin with iron) supplementation?

Starting Age for Poly-Vi-Sol (Multivitamin with Iron)

Healthy, full-term infants can begin Enfamil Poly-Vi-Sol multivitamin with iron at 6 months of age if they are breastfed and not receiving adequate iron from complementary foods. 1

Timing Based on Feeding Method

Breastfed Infants

• Start iron supplementation at 6 months when iron stores from birth become depleted and complementary foods are insufficient to provide approximately 1 mg/kg/day of iron 2, 1
• Term infants are born with adequate iron stores that last approximately 4-6 months 1
• Iron becomes critical after 6 months, with requirements of 0.9-1.3 mg/kg/day 1
• The CDC and AAP recommend 1 mg/kg/day of iron drops for breastfed infants who receive insufficient iron from supplementary foods by age 6 months 2, 1

Formula-Fed Infants

• Iron-fortified formula eliminates the need for additional iron supplementation in healthy term infants 2
• Only use iron-fortified infant formula (containing 4-12 mg/L iron) as a substitute for breast milk in infants under 12 months 2, 1
• Formula-fed infants receiving iron-fortified formula do not require additional multivitamin with iron 3

Special Populations Requiring Earlier Supplementation

Preterm or Low Birthweight Infants

• Start iron drops at 1 month of age with 2-4 mg/kg/day (maximum 15 mg/day) and continue until 12 months 2
• These infants are born with lower iron stores and deplete them by 2-3 months of age 4
• Marginally low-birth-weight infants (2000-2500 g) should receive 1-2 mg/kg/day 5

Critical Implementation Details

Dietary Context at 6 Months

When starting Poly-Vi-Sol at 6 months, simultaneously introduce:

• Iron-fortified infant cereal (2+ servings daily can meet iron requirements alone) 2, 1
• Vitamin C-rich foods with meals to enhance iron absorption 2, 1
• Pureed meats when developmentally ready (after 6 months) 2, 1

Common Pitfalls to Avoid

• Do not delay iron supplementation beyond 6 months in exclusively breastfed infants without adequate iron-rich complementary foods, as 15-25% are at risk for iron deficiency by 9-12 months 1, 4
• Never use cow's milk, goat's milk, or soy milk before 12 months as they contain minimal bioavailable iron and increase iron deficiency risk 2, 4
• Limit milk intake to <24 oz daily after 12 months to prevent displacement of iron-rich foods 4, 6

Screening Recommendations

High-Risk Populations

Screen for anemia at 9-12 months, then 6 months later, then annually ages 2-5 years in:

• Children from low-income families 2
• WIC-eligible children 2
• Migrant or refugee children 2

Risk Factors Requiring Earlier Assessment

Consider screening before 6 months for:

• Preterm or low-birthweight infants not on iron-fortified formula 2
• Infants fed non-iron-fortified formula for >2 months 2
• Infants introduced to cow's milk before 12 months 2
• Breastfed infants with inadequate dietary iron after 6 months 2