Iron Nutrition in Low-Birth-Weight Infants

Since the early 1920s pediatric textbooks have recognized that infants often become anemic a few months after a preterm birth. However, except for its greater severity, the anemia does not differ in any way from that of full-term infants. It can be divided into an early and a late anemia of prematurity. The early anemia represents the initial fall in concentration of hemoglobin which occurs during the first 2 months after birth. The degree of severity varies with the gestational age and the vitamin E nutrition of the premature. In contrast, the late anemia may start at any time from 2 months on, depending on the time when the premature infant's iron supply is exhausted. Over the last 60 years, increasing doses of iron have been recommended for prematures in order to compensate for the rapid growth and to prevent the late anemia. Daily doses of 10 or 20 mg/kg body weight are currently being given by many pediatricians. These doses are far above what we currently consider to be optimal for these infants.