Nutrient Needs During the First Two Months of Life

Minerals

In general, recommendations for mineral intakes for young children are based on average intakes of breastmilk. Unless a special medical need changes an infant’s ability to metabolize a mineral or significantly affects overall intake, breastmilk and/or standard, iron-fortified infant formula should meet an infant’s mineral needs.

iron
zinc

Iron
Iron deficiency anemia is associated with cognitive and motor impairments in infancy and into later childhood (Lozoff et al, 2006). For term infants whose mothers did not have iron deficiency anemia, iron stores are high at birth. Iron is significantly more bioavailable in human milk (45-100%) than in infant formula (10%).

Both iron intake (amount of breastmilk and/or formula) and iron requirements are related to body size and growth rate. It is expected then, that the needs of most infants will be met if their overall intakes are primarily breastmilk or iron-fortified infant formula and are adequate to support appropriate growth.

Iron needs of infants born prematurely may be higher, since the majority of iron accretion occurs during the last trimester of pregnancy and preterm infants experience more rapid postnatal growth than infants born at term. Additionally, preterm infants often have more frequent blood draws for lab monitoring, Supplemental iron (2 mg/kg/day) starting at age 1 month is recommended for preterm infants who are breastfed. Supplementation for formula-fed preterm infants may be necessaryy, but no general recommendations exist. (AAP, 2010)

Zinc
Zinc absorption from breastmilk is highest (41%); zinc from cow’s milk formula is more bioavailable (31%) than zinc in soy-based formulas (14%). Zinc concentration in human milk is unaffected by maternal diet and declines rapidly in the first six months of lactation. After the first 6 months, human milk is an inadequate source of zinc.

Growth delays have been seen in infants fed infant formulas with low amounts of zinc, and zinc supplementation has been found to improve growth in infants with failure to thrive.