Vitamin and Iron Supplements for Pre-term Infants

Premature infants -- babies born before 37 weeks -- have unique nutritional needs. Babies born early may have lower vitamin and mineral stores than babies born after a full-term pregnancy. Preterm infants may also have higher nutritional needs for not only calories, but also for vitamins and minerals for some time. Most preterm infants need supplemental vitamins, as well as iron, unless they’re taking specially fortified formulas made for premature infants that contain the required amount of nutrients.

Types Supplements

Preterm infants need supplementation of certain vitamins. Infant formulas are fortified with vitamins such as vitamins A,D,E,C, folate, calcium, phosphorus and iron. Human breast milk has many benefits for preterm infants, but infants given breast milk fortified with additional vitamins and mineral may have improved growth rates, better bone mineralization, improved protein metabolism and stabilization of calcium, phosphorus and alkaline phosphorus levels, the Oregon Department of Human Services states.

Iron Deficiency Causes


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Full-term infants are born with enough iron stores to last the first 4 to 6 months after birth. Most of the iron stores accumulated during the last three months of pregnancy. Babies born prematurely have less iron to draw on after birth. In addition, premature babies have frequent blood draws, which can also deplete iron stores in red blood cells. Decreased production of erythropoietin, a hormone that governs production of red blood cells, occurs in premature infants because erythropoietin is still produced in the liver in premature infants. In full-term infants, the kidneys produce erythropoietin.

Iron Doses

Iron supplements should be started before 2 months of age and can be safely started as early as two weeks after delivery, according to the Vanderbilt University Medical Center. As a general rule, infants weighing less than 1,000 g or 2.2 lbs. need 4 mg/kg/day of elemental iron supplementation, while infants over 1,500 g, or 3.3 lbs, need 2 mg/kg/day. Infants who weigh between 1,000 and 1,500 g may also benefit from 4 mg/kg/day. Babies taking extra erythropoietin in the form of Epogen need 6 mg/kg/day.

Formula Types


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Fortified formulas for preterm infants with 24 calories per ounce, or transitional formulas that supply 22 calories per ounce, compared to regular formula, which has 20 calories per ounce, contain 2 mg of iron. Formulas with 24 calories per ounce also contain adequate vitamin supplementation. Premature babies taking breast milk need supplemental vitamins and iron. A baby drinking 24 to 32 oz. of regular formula gets enough vitamin and mineral supplementation. Babies drinking less than 16 oz. of regular formula per day need a standard infant multivitamin supplement.