Related Experiment Video
Updated: May 5, 2026
Quantitating Iron Transport Across the Mouse Placenta In Vivo Using Nonradioactive Iron Isotopes
Published on: May 10, 2022
Iron deficiency and anemia in iron-fortified formula and human milk-fed preterm infants until 6 months post-term
Monique van de Lagemaat1, Eline M Amesz, Anne Schaafsma
1Department of Pediatrics, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands, m.vandelagemaat@vumc.nl.
Insights
Preterm infants fed iron-fortified formula (IFF) had adequate iron levels up to 6 months post-term without supplementation. Human milk-fed preterm infants required iron supplementation to maintain sufficient iron stores.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Infant Health
Background:
- Preterm infants have higher iron requirements, with recommendations exceeding 2 mg/kg/d.
- Adequate iron intake is crucial for neurodevelopment and preventing anemia in infants.
- Previous studies suggest varying iron needs based on feeding type in preterm populations.
Purpose of the Study:
- To evaluate iron status in preterm infants fed human milk (HM) versus iron-fortified formula (IFF) up to 6 months post-term.
- To determine the necessity of iron supplementation for HM-fed preterm infants after discharge.
- To assess if IFF provides sufficient iron to preterm infants until 6 months post-term, negating the need for supplementation.
Main Methods:
- An observational study measuring ferritin levels at term, 3, and 6 months post-term in 92 IFF-fed and 46 HM-fed preterm infants.
- Calculation of iron intake (mg/kg/d) from term age to 6 months post-term for both groups.
- Comparison of ferritin concentrations and incidence of low ferritin (<12 μg/l) between HM-fed and IFF-fed infants.
Main Results:
- Higher rates of iron supplementation were observed in both groups between term and 3 months post-term (71.7% HM-fed, 83.7% IFF-fed).
- By 3 to 6 months post-term, supplementation decreased significantly in HM-fed infants (13%) but ceased in IFF-fed infants (0%).
- HM-fed infants showed a significantly higher incidence of low ferritin (<12 μg/l) at 3 and 6 months post-term compared to IFF-fed infants (23.8% vs. 7.8% and 26.3% vs. 9.5%, respectively).
Conclusions:
- Preterm infants fed human milk exhibit a higher prevalence of low ferritin levels up to 6 months post-term, potentially due to early cessation of iron supplementation.
- Iron-fortified formula (0.8-1.0 mg iron/100 ml) appears to provide sufficient iron for preterm infants, maintaining adequate ferritin levels without additional supplements between 3 and 6 months post-term.
- This suggests that iron supplementation may not be necessary for preterm infants exclusively fed with appropriately iron-fortified formula.
Purpose:
An iron intake of >2 mg/kg/d is recommended for preterm infants. We hypothesized that human milk (HM)-fed preterm infants require iron supplementation after discharge, whereas iron-fortified formulae (IFF; 0.8-1.0 mg iron/100 ml) may provide sufficient dietary iron until 6 months post-term.
Methods:
At term age, 3 and 6 months post-term, ferritin (μg/l) was measured in 92 IFF-fed infants (gestational age (median (interquartile range)) 30.7 (1.4) weeks, birth weight 1,375 (338) gram) and 46 HM-fed infants (gestational age 30.0 (1.7) weeks, birth weight 1,400 (571) gram). Iron intake (mg/kg/d) between term age and 6 months post-term was calculated.
Results:
Iron was supplemented to 71.7% of HM-fed and 83.7% of IFF-fed infants between term age and 3 months post-term and to 13% of HM-fed and 0% of IFF-fed infants between 3 and 6 months post-term. IFF-fed infants had an iron intake from supplements and formula of 2.66 (1.22) mg/kg/d between term age and 3 months post-term and 1.19 (0.32) mg/kg/d between 3 and 6 months post-term. At 3 and 6 months post-term, the incidence of ferritin <12 μg/l was higher in HM-fed compared to IFF-fed infants (23.8 vs. 7.8% and 26.3 vs. 9.5%, P < 0.02).
Conclusion:
This observational study demonstrates that ferritin <12 μg/l is more prevalent in HM-fed infants until 6 months post-term. This may be due to early cessation of additional iron supplementation. We speculate that additional iron supplementation is not necessary in preterm infants fed IFF (0.8-1.0 mg iron/100 ml), as they achieve ferritin ≥12 μg/l without additional iron supplements between 3 and 6 months post-term.
More Related Videos
09:36Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers
Published on: July 28, 2022
05:35Author Spotlight: Developing a Point-of-Care Hemoglobin Estimation Method for Anemia Management
Published on: January 19, 2024
Related Concept Videos
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
01:30Development of Human Microbiota
01:28The Early Endosome: Endocytosis of Transferrin
01:19Rh Blood Group
01:28Development of the Oral Microbiota
01:15Transcytosis of IgG
IgG molecules from a mother undergo transcytosis starting around 13 weeks of gestation. The amount of IgG transferred and entering the fetal blood circulation increases with...