I am confused about iron supplementation and the bio-availability of the iron in breastmilk for my baby. He was born at 34 weeks and received iron supplements for about 2 months after birth, first in the NICU and then in his first few weeks home. It's done, and most of it had to do with the NICU, so I don't want to get into whether or not that was the correct thing to do, I'm just trying to figure out what to do now.
At that point, about 2 months ago, our pediatrician said that he didn't need them, but would need supplements again starting at 4 months from birth, which is where we are now. At our appointment today she told us to start supplementing, in addition to tri-vi-sol (which we're not doing -- she said it was only important for the vitamin D, and that's a whole different issue).
I've read that iron supplementation reduces the baby's ability to absorb the iron in breast milk. Is that effect permanent, or just while baby is being supplemented? He had more than enough iron in his blood 2 months and about 3.5 pounds ago -- could he still be drawing on that supply. I hesitate to supplement partly because he seems to have uncomfortable and infrequent (every 4 days or so) poos... but I can't just follow the "no supplements necessary for full term EBF babies in the first six months" line because he wasn't full term, and has already had some supplements.
I would get him tested, but I doubt that the doctor would write an order for it, We can't switch because there are vanishingly few doctors in our area. Any of the half-decent ones don't take new patients, and in some ways she's a good doctor, but I don't take her word as gospel, because I've disagreed with a few things she's said (she's pretty negative about extended breastfeeding, for example). So at the moment I feel like i have to guess.
For this, I would definitely ask. There are risks of not supplementing if baby is low and needs it, and risks of supplementing if baby doesn't need it. The safest, best medicine is to see what baby needs. Who knows, she may surprise you! :)
Also, you may want to post in Health and Healing of Preemie/NICU parenting, as there may be evidence for all premature babies to be supplemented with iron without testing. My knowledge is just about term babies (see kellymom above). Good luck!
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