In preterm infants, iron supplementation is advised starting in which age range?

• A. 0-4 weeks
• B. 4-8 weeks
• C. 9-12 months
• D. 1-12 months

Answer: (D)

Preterm infants are born with much lower iron stores because the main transfer of iron from mother occurs in the third trimester. Without supplementation, these stores can run out within the first months of life, increasing the risk of iron deficiency anemia, which can impact growth and neurodevelopment. To prevent this, iron supplementation is started early in infancy—after enteral feeding is established—and continued through the first year of life. Starting within the first year best matches the period when iron needs are rising and stores are limited, making it the most appropriate window. The exact timing and dose are tailored to weight, feeding method, and lab values, but the important point is to begin iron support during infancy.