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Iron status of very-low-birth-weight infants during the first 15 months of infancy
J K Friel1, W L Andrews, J D Matthew
1Department of Biochemistry, Memorial University of Newfoundland, St. John's.
Insights
Iron stores in very low birth weight infants are inadequate, even with iron-fortified formula and cereal. Depleted iron stores were observed in over half of infants by 12 months, indicating a need for continued iron supplementation.
Area of Science:
- Pediatrics
- Neonatology
- Nutritional Science
Background:
- Iron deficiency is a concern in premature infants.
- Adequacy of iron stores in Canadian very low birth weight infants is not well-established.
Purpose of the Study:
- To assess iron status in very low birth weight infants in Canada.
- To determine the adequacy of iron stores throughout infancy in this population.
Main Methods:
- Prospective monitoring of iron status in 81 very low birth weight infants.
- Assessment of plasma ferritin levels at 3, 6, 9, 12, and 15 months of age.
- Evaluation of iron intake from fortified formula and cereal.
Main Results:
- Plasma ferritin levels decreased after cessation of iron-fortified formula.
- Despite iron-fortified cereal, plasma ferritin levels continued to decline.
- 54% of infants had depleted iron stores (<10 µg/L) by 12 months, rising to 74% by 15 months.
Conclusions:
- Very low birth weight infants exhibit inadequate iron stores despite standard iron fortification.
- Delayed development affects cereal intake, necessitating iron-fortified formula throughout infancy.
- Continuous iron supplementation is crucial for very low birth weight infants to prevent iron deficiency.
Abstract:
The adequacy of iron stores in infants of very low birth weight (defined as less than 1500 g) in Canada is unknown. We monitored the iron status of 81 such infants at 3, 6, 9, 12 and 15 months of age. All of the infants were fed formula fortified with iron (13 mg/L) for at least 6 months, starting at 2 months of age. The plasma ferritin level decreased after the formula was no longer used. Although 90% of the infants were given cereal fortified with iron (30 mg of iron per 100 g) by 9 months of age, the plasma ferritin level continued to decrease. The level was less than 10 micrograms/L in 54% of the infants at 12 months of age and in 74% at 15 months; this indicated depleted iron stores. Because of delayed development very-low-birth-weight infants eat small amounts of cereal and therefore require iron-fortified formula throughout infancy.