The importance of iron in neonatal and infant nutrition

Objective: Summarize the role of iron in fetal and neonatal nutrition. Findings: Iron is an essential micronutrient that plays key roles in growth and development of the fetus and neonate. Iron deficiency compromises erythropoiesis, immune competency, and when present during critical periods of brain development, long-term neurodevelopmental outcomes. Due to the critical role of iron in shaping brain structure and development, these deficits may be irreversible with later repletion. Conversely, oversupplementation with iron, a potential pro-oxidant, may also have detrimental effects. Therefore, neonatal iron supplementation should be individualized and monitored through iron measures in those at high-risk for iron deficiency to optimize outcomes. A variety of enteral and parenteral iron approaches are available to meet the needs of infants at low and high risk of iron deficiency. Conclusion: Optimizing iron status in neonates is key to improving growth and development in infants. Preterm infants are at particular risk for disruptions in iron status and thus warrant iron supplementation and close surveillance of iron status.