Iron Therapy for Preterm Infants

[Dr.Vad]

Clin Perinatol. 2009 March; 36(1): 27–42.
Iron Therapy for Preterm Infants.
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[Dr.Vad]

Risk factors associated with a higher prevalence of iron deficiency anemia (IDA) include:
low birth weight,
high cow's milk intake,
low intake of iron-rich complementary foods,
low socioeconomic status and immigrant status.

There is no evidence that iron supplementation of pregnant women improves iron status in their offspring in a European setting. Delayed cord clamping reduces the risk of iron deficiency. There is insufficient evidence to support general iron supplementation of healthy, European infants and toddlers of normal birth weight.

Formula-fed infants up to 6 months of age should receive iron fortified infant formula, with an iron content of 4-8 mg/L (0.6-1.2 mg/kg/d).
Marginally low birth weight infants (2000-2500 g) should receive iron supplements of 1-2 mg/kg/d. Follow-on formulas should be iron-fortified. From the age of 6 months, all infants and toddlers should receive iron-rich (complementary) foods including meat products and/or iron fortified foods.
Unmodified cow's milk should not be fed as the main milk drink to infants before the age of 12 months and intake should be limited to <500 mL daily in toddlers.

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J Pediatr Gastroenterol Nutr. 2013 Oct 16. Iron Requirements of Infants And Toddlers: A Position Paper By The ESPGHAN Committee on Nutrition.

[voyager001]

Дилемма... С "искусственниками" и с младенцами старше 6 месяцев все понятно. При ЖДА можно использовать обогащенные железом смеси... Но вот как быть с младенцами на естественном вскармливании до 6 месяцев с ЖДА? С одной стороны жестко внедряется политика грудного вскармливания, с другой стороны становится понятно, что лучший выход при лечении ЖДА у младенцев - искусственные смеси обогащенные железом....

[Dr.Vad]

Грудное вскармливание должно быть приоритетом в любой ситуации, если есть ЖДА - препарат железа в каплях в соотв. дозе; в регионах, где частота выявления ЖДА у детей первого года более 25-30%, рекомендуется пр-т железа с 4 мес. всем детям.

[Dr.Vad]

...guidelines recommend giving iron supplements at a dose of 1–2 mg/kg/day up to 6 months of age to infants with birth weights of 2000–2500g (21). We agree with this recommendation and, additionally, recommend a post discharge dietary iron intake of 2 mg/kg/day for infants with a birth weight of 1500–2000 g. Iron supplements or intake of iron-fortified formula in the recommended doses should be continued for at least 6–12 months of age, depending on diet. Hemoglobin and serum ferritin should be checked at follow-up visits and assessed in comparison with reference levels for different ages.

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