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Assessment of different folic acid supplementation doses for low-birth-weight infants
Fatma Çakmak Çelik1, Canan Aygün1, Sedat Gülten2
1Division of Newborn, Department of Pediatrics, Ondokuz Mayıs University School of Medicine, Samsun, Turkey.
Insights
The study found that 25 mcg/day of folic acid is adequate for low-birth-weight infants, as higher doses did not significantly improve folate levels. This dosage ensures sufficient folate for these vulnerable newborns.
Area of Science:
- Neonatal Nutrition
- Maternal-Fetal Medicine
- Nutritional Biochemistry
Background:
- Low-birth-weight infants are at risk for nutritional deficiencies.
- Folic acid is crucial for infant development and preventing neural tube defects.
- Optimal folic acid supplementation for low-birth-weight infants requires investigation.
Purpose of the Study:
- To determine the adequacy of 50 mcg folic acid supplementation in low-birth-weight infants.
- To investigate folate levels in mothers, infants, and breast milk.
- To establish the optimal folic acid dose for low-birth-weight infants.
Main Methods:
- 141 low-birth-weight infants were randomized into three groups receiving 25, 50, or 75 mcg/day of folic acid.
- Serum and red cell folate levels were measured at baseline and after supplementation.
- Maternal serum/red cell folate and breast milk folate levels were also assessed.
Main Results:
- Infant birth weight averaged 1788.2g and gestational age 33.5 weeks.
- Maternal folic acid supplementation during pregnancy significantly increased breast milk folate levels.
- All folic acid supplementation groups showed increased serum folate levels, with no significant inter-group differences.
Conclusions:
- Folic acid doses of 25, 50, and 75 mcg/day similarly impacted serum folate levels in low-birth-weight infants.
- A daily dose of 25 mcg/day is considered adequate for low-birth-weight infants.
- This finding supports evidence-based neonatal nutritional guidelines.
Aim:
The adequacy of 50 mcg folic acid supplementation given to low-birth-weight babies was investigated. The folate levels of the mothers and infants, and breastmilk, and the optimum dose for folic acid supplementation were also investigated.
Material And Methods:
After obtaining blood from 141 low-birth-weight infants on the 1st day of life for serum and red cell folate levels, the infants were randomly allocated into three groups according to the folic acid supplement dose. Forty-six infants were given 25 μg/d folic acid, 39 were given 50 μg/d folic acid, and 44 were given 75 μg/d folic acid. Folic acid could not be given to 12 infants. Follow-up blood samples were obtained at the end of folic acid supplementation. Maternal samples for red cell and serum folate levels and breast milk folate levels were obtained within the first 48 hours and the samples for measuring breastmilk folate level were obtained on the 3rd day postnatally. The feeding modes of the infants, maternal folic acid intake, and details of neonate intensive care unit course were recorded.
Results:
The mean birth weight and gestational age of the infants were found as 1788.2±478.4 g and 33.5±2.9 weeks, respectively. The mean serum and red cell folate levels on admission were found as 21.2±12.2 ng/mL and 922.7±460.7 ng/mL, respectively. The mean maternal serum and red cell folate levels and the mean breast milk folate levels were found as 12.3±7.5 ng/mL, 845.5±301.4 ng/mL, and 30.6±33.0 ng/m, respectively. The breast milk folate levels of mothers who were supplemented with folic acid during pregnancy were significantly higher compared with mothers who were not supplemented with folic acid (p<0.001). Infants who were supplemented with folic acid had higher follow-up serum folate levels compared with the basal level in all groups, but there was no statistically significant difference between the groups.
Conclusion:
This study showed that the folic acid doses of 25, 50, and 75 μcg/d affected serum folate levels similarly. We can conclude that the dose of 25 μcg/d is adequate for low-birth-weight infants.
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