Key points about iron (ferrous sulphate) for premature and small babies
- iron is vital for body function
- it is especially important for supporting healthy growth and brain development
- iron helps transport oxygen from the lungs to the rest of the body
- having low levels of iron can lead to low levels of red blood cells (anaemia) in the body
Why iron is important
Pēpi need good levels of iron in their body to:
- help transport oxygen from the lungs to the rest of the body
- support brain development and learning
- provide energy
- support healthy growth
In the last few months of pregnancy, your baby stores iron in their body to use after they are born. Most full-term pēpi are born with enough iron stores to last until around 6 months of age, so they usually don’t need iron medicine
Why some babies need extra iron
Some pēpi do not have as much iron stored in their body. The iron they do have is used up as they grow. They need extra iron to prevent iron deficiency.
These pēpi include:
- premature pēpi (pēpi who were born early - before 37 weeks)
- those who are small (weighed less than 2.5 kg at birth)
How much iron babies need
Your baby's iron dose will depend on their weight. Your health professional can increase the dose with each new prescription as your baby gains weight. In most cases, pēpi have iron once a day.
When to start taking iron medicine
Very premature babies
If your baby was very premature, they will start having iron medicine when they are in the hospital.
Babies born under 37 weeks or under 2.5 kg
You may need to start giving iron medicine after your baby goes home if:
- your baby was born under 37 weeks or
- your baby weighed less than 2.5 kg at birth
Your health professional will tell you when to start giving your baby iron medicine. This is usually around 2 weeks after birth.
When to stop taking iron medicine
Keep giving iron each day until your child's first birthday or your health professional asks you to stop.
Your health professional will need to increase the dose as your baby grows.
How to give iron to your baby
You can use a syringe or a medicine teat to give iron to your baby. It absorbs better on an empty stomach so try to give it before a feed. If this is difficult you can give the iron with a small amount of breastmilk to make it taste better. But, give the iron between meals once your baby is established on solids.
What if my baby vomits?
If your baby vomits less than 30 minutes after giving the iron, give the same dose again. If it is more than 30 minutes, do not give another dose until it is next due. If your baby vomits or spits up this may also be a darker colour.
Effects of iron in babies
Pēpi react to the taste, but this does not mean it is a problem. Your baby's poo (bowel motions) may become a darker colour, but this is OK. The poo can become a little firmer and some pēpi become constipated when they first start taking iron, but this usually settles. If you have any worries, talk to your health professionals.
Storing iron medicine
Keep the medicine in its container and out of reach of tamariki (children). It is a good idea to store it in a cupboard, away from heat and direct sunlight. You do not need to keep it in the fridge. The syrup is normally colourless, but if the colour varies from bluish green to gold this is OK.
Acknowledgements
The content on this page has been developed and approved by the Clinical Reference Group of the Newborn Clinical Network, Paediatric Society New Zealand.
