Being born at 34 weeks gestation has *everything* to do with the
problem.  I think there is some misunderstanding about breastfeeding
and iron.  The oral bioavailability of breastmilk iron is very
important, but the baby gets his iron stores from the mother during
pregnancy, the majority in the last trimester.  If the baby is born
prematurely, then he misses out on a large portion of his iron stores,
and *despite* the high oral bioavailability of breastmilk iron, the
baby will become iron deficient if not given iron in addition.  Most
pediatricians will suggest iron supplements for premature babies,
sometimes unnecessarily, but if the baby is born at 34 weeks, I would
say this is probably necessary.

A full term baby is usually born with a full store of iron.
Breastmilk keeps the stores from dropping too low but breastmilk alone
cannot fill up the stores.  Even in the full term baby, breastmilk
will not keep up, eventually, with maintaining stores.

The mother does *not* have to cut down on breastfeeding, though.  She
really should give the iron.

Jack Newman, MD, FRCPC