Preterm infants, at risk for retinopathy of prematurity, need to be maintained Vitamin E sufficient (range: 0.8 to 1.2 U/ml) with appropriate Vitamin E supplements. Since iron is a potent pro-oxidant and free radical donor, it effectively increases the need for Vitamin E. Based on these considerations, iron supplementation has been delayed in our ICN until retinal vasculature matures. The iron status and need for supplementation was evaluated in 50 growing preterm infants (mean ± SD birthweight = 1019 ± 23.8 gm, range: 650-1370 gm). The only presumable source of iron was packed red blood transfusion administered during the ICN stay (total mean blood received ± SD: 374 ± 255 ml). Serum Iron (SI) and transferrin saturation (SAT) were determined at birth and biweekly until eyes were mature. Mean ± SD values at 8, 10, 12 wks postnatal age appear below:

These data indicate that infants in the ICN remain iron sufficient and the use of iron containing formulas may be delayed, in the occasional infant who requires little or no blood and therefor does not add to his iron stores in the nursery, the delay in providing an iron supplement can be compensated for by prescribing Poly-visol with Iron. A dosage of I ml/day for one month provides about as much iron as a daily intake of 24 oz. of iron-enriched formula over a six week period.

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Abbasi, S., Bhutani, V., Fong, E. et al. DELAYED IRON SUPPLEMENTATION IN PRETERM INFANTS. Pediatr Res 18, 189 (1984).

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