Iron for Premature Infants--Is Formula the Best Way?

Extra iron is part of physicians' nutritional strategies for newborn premature infants. But they disagree on whether their tiny patients should get the iron along with their formula or between feedings. A new study at the Children's Nutrition Research Center in Houston, Texas, concludes iron-fortified formulas are a good option.

While the researchers found that premature infants actually made 2 percent better use of iron given separately, this very small increase is not significant compared to the extra effort required and the possible stomach irritation that can come with giving iron as a separate supplement.

It is simpler and effective to use iron-enriched formulas for premature infants when breast feeding isn’t an option. Giving premature infants iron-fortified formula enables them to “graduate” from the hospital sooner and join their families at home.

The Houston center is a cooperative venture of the Agricultural Research Service and Baylor College of Medicine. ARS is USDA's chief scientific agency.

Pediatric nutritionists have long agreed that extra iron can also push up red blood cell production. As a result, many milk formulas designed for preemies are fortified with iron.

But researcher Steven A. Abrams, an expert in metabolism research at the Houston center, wanted to scientifically confirm the optimal method of providing iron to preemies. High levels of calcium are contained in formulas used for premature infants. Could the extra calcium interfere with the iron absorption? Abrams and a research team decided to find out.

They traced red blood cell iron use in 13 premature infants given both kinds of iron treatments. They used stable isotopes of iron to compare the rate at which the infants’ bodies used the iron in formulas versus separate supplements.

Scientific contact: Steven A. Abrams, ARS Children’s Nutrition Research Center at Baylor College of Medicine, Houston, Texas, phone (713) 798-7124, fax (713) 798-7119, sabrams@bcm.tmc.edu.