Vitamins, iron supplements and nutrition during the first year of life for infants with a birth weight under 2.5 kg
Premature babies need vitamin and iron supplements. Here you will find information about which supplements your baby should receive, and in what amounts.
Vitamin D
It is recommended that all children in Norway receive vitamin D supplementation.
Exclusively breastfed / breast milk–fed infants should receive vitamin D supplementation from around 7 days of age. We use Nycoplus vitamin D drops, 5 drops daily.
Infant formula is fortified with vitamin D. If the baby receives at least 600 ml of infant formula per day, no additional vitamin D supplementation is needed.
If the baby receives less than 600 ml of infant formula per day, we recommend giving 3 vitamin D drops daily.
The child should continue vitamin D supplementation after the age of 1 year.
Iron
Premature infants and babies with a low birth weight have low iron stores at birth. Without additional iron supplementation, they may develop anaemia (iron deficiency anaemia). Iron supplementation is also important for cognitive (brain) development.
Maltofer® iron drops 50 mg/ml (1 drop = 2.5 mg iron)
Maltofer iron drops can be purchased over the counter at pharmacies.
Start: From 4 weeks of age
Dosage:
- Until the baby weighs 3.5 kg: 2 drops daily*
- From 3.5 kg: 3 drops daily*
*For infants receiving iron-fortified porridge daily: 2 drops daily
Duration:
- Birth weight under 2 kg: throughout the baby's first year
- Birth weight 2.0–2.5 kg: until 6 months of age. Infants in this weight group may stop iron at 6 months if they are eating iron-fortified porridge.
Iron may cause dark-coloured stools and occasionally abdominal discomfort. If there is significant discomfort, the dose can be reduced for a period. If iron is stopped completely (not recommended before corrected age of 6 months), haemoglobin (Hb + MCV) and possibly iron stores (ferritin) should be checked by the GP.
Nutrition
Breast milk is the best option, and for all babies whose mothers are able to breastfeed, this is recommended.
For infants who weighed less than 1800 grams at birth and are not breastfed, we recommend a specially adapted infant formula designed for premature babies. This can be given until 3–4 months corrected age (the age the child would have if calculated from the due date). This provides extra calories and protein, which is beneficial for growth and development.
After 3–4 months corrected age, the baby can be given standard infant formula.
It is recommended to introduce solid foods, such as porridge, from around 4 months corrected age, but no later than 6 months chronological age. This means that solid foods should be introduced no later than 6 months after birth.
Regular cow’s milk is recommended from 1 year corrected age.