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There is nothing to worry about. This is a normal physiologic process that occurs in all newborns but in premature infants, the drop in Hgb occurs a little earlier and is greater. Preemies drop their Hgb to about 8 gm/dL around the 4-8 week mark. Full term infants drop to an average of 11.5 gm dL, by 6-10 weeks. This phenomenon is called nadir. The drop does not occur because of lack of iron stores, instead the production of red blood cells drops off to allow the infant to adapt to life outside the uterus. This is referred to as the reticulocyte production and it drops from 6-10% down to < 1%, by 5 days of age. Your baby's Hgb actually reflects that he is starting to climb back up from his lowest point. Your pediatrician should have explained this to you so as not to cause you undue worry. Give your son the iron, as prescribed. Good luck and enjoy your little miracle.





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