Iron for preterm infants

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Preterm infants are born with very low iron stores, and rapid growth further stresses their limited iron stores. Although it is standard practice to supplement preterms with iron, there is no consensus about when to begin oral iron supplement or how much iron can be safely given. The major concern has been that iron-induced oxidant stress may result in tissue injury.

Brække et al report an observational study from Norway of the initiation of supplemental oral iron therapy with 18 mg iron daily beginning at 6 weeks of age. The daily dose ranged from 8 to 16 mg/kg in the very low birth weight infants. This dose is much higher than is generally used. Nevertheless, there was no indication of increased oxidant products or injury one week after the therapy was started. Very low birth weight infants seem to tolerate high dose iron therapy well.