Answer to Question#01

Question#01

A healthy, 39-week gestation male weighing 3.5 kg is born to a mother who has chronic anemia. The infant’s physical examination findings are normal, and his hematocrit is 49% (0.49). The mother asks you about the need for vitamins and iron for her newborn son.

Of the following, the BEST response is that term babies need to begin iron therapy at

A. Birth

B. 2 weeks of age

C. 4 months of age

D. 9 months of age

E. No time

Answer to Question#01 is 'C'

Term newborns have accrued sufficient iron stores in the latter part of gestation to sustain them for 3 to 4 months after birth; this is true even when the mother has anemia. Although human milk contains lower quantities of iron, its bioavailability is greater and, therefore, breastfed infants do not require replacement therapy until 4 months of age.

Preterm infants miss out on iron accretion in utero during the last trimester of pregnancy and may require iron supplementation if they are taking full-volume enteral feedings as early as 2 to 4 weeks of age. Iron supplementation is not required at birth except in the rare circumstance of congenital anemia. Iron supplementation is required for normal hematopoiesis and brain growth and function, and if not provided by 6 months of age, characteristically leads to iron deficiency anemia.