title: Iron deficiency and anemia in iron-fortified formula and human milk-fed preterm infants until 6 months post-term.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, VU University Medical Center, PO Box 7057, 1007 MB, Amsterdam, The Netherlands, m.vandelagemaat@vumc.nl.
authors.forename: Monique
authors.initials: M
authors.lastname: van de Lagemaat
authors.forename: Eline M
authors.initials: EM
authors.lastname: Amesz
authors.forename: Anne
authors.initials: A
authors.lastname: Schaafsma
authors.forename: Harrie N
authors.initials: HN
authors.lastname: Lafeber
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000188:drug therapy / Q000453:epidemiology*; D001724:Birth Weight; D001823:Body Composition; D001827:Body Height; D001835:Body Weight; D019587:Dietary Supplements; D005260:Female; D005293:Ferritins / Q000097:blood; D005527:Food, Fortified; D006801:Humans; D015994:Incidence; D007223:Infant; D041943:Infant Formula / Q000737:chemistry*; D007234:Infant, Premature / Q000254:growth & development*; D019266:Iron, Dietary / Q000008:administration & dosage*; D008297:Male; D008895:Milk, Human / Q000737:chemistry*; D016032:Randomized Controlled Trials as Topic
chemical_list: D019266:Iron, Dietary; D005293:Ferritins