Related Experiment Videos
Vitamin D requirement in infants receiving parenteral nutrition
Insights
Low dose vitamin D (25 IU/dl) in parenteral nutrition (PN) is adequate for infants, maintaining normal growth and vitamin D levels for up to six months. This supports infant health during surgical recovery.
Area of Science:
- Pediatrics
- Nutritional Science
- Clinical Nutrition
Background:
- Parenteral nutrition (PN) is essential for infants with surgical indications.
- Maintaining adequate vitamin D status is crucial for infant growth and development.
- The optimal dosage of vitamin D in PN for infants requires investigation.
Purpose of the Study:
- To assess the adequacy of a low dose of vitamin D (25 IU/dl) in parenteral nutrition (PN) for infants.
- To evaluate the impact of this PN regimen on infant growth and vitamin D status.
- To examine biochemical markers related to vitamin D metabolism and bone health in infants receiving PN.
Main Methods:
- A study involving 18 infants receiving PN with 25 IU/dl vitamin D.
- Monitoring of infant growth parameters (weight, length, head circumference).
- Measurement of serum 25 hydroxyvitamin D (25 OHD), calcium, phosphorus, magnesium, and alkaline phosphatase (AP) levels.
- Radiographic assessment of bone mineralization.
Main Results:
- Infants maintained normal growth percentiles throughout the study period (up to 6 months).
- Serum 25 OHD levels increased significantly and remained within the normal range.
- Biochemical markers for liver function, calcium, and phosphorus were generally normal.
- Mildly elevated magnesium and transient increases in AP were observed in some infants, with most resolving spontaneously.
Conclusions:
- A low dose of 25 IU vitamin D/dl in PN is adequate for maintaining normal vitamin D status in infants.
- This dosage supports normal growth and development in infants requiring long-term PN.
- While most infants tolerated the regimen well, careful monitoring of AP and magnesium is advisable.
Abstract:
The adequacy of low dose vitamin D (25 IU/dl) parenteral nutrition (PN) solution was studied in 18 infants. All infants had surgical indications for PN. The birth weights were 2810 +/- 135 g and gestational ages 37.4 +/- 0.5 wk (mean +/- SEM). Duration of study ranged from 5 to 175 days. Thirteen infants were studied for up to 6 weeks and five infants for 71 to 175 days. Results showed that studied infants maintained growth along normal percentiles for weight, length, and head circumference. Vitamin D status as indicated by serum 25 hydroxyvitamin D (25 OHD) rose from 15 +/- 1.9 ng/ml to 26 +/- 2.8 ng/ml, mean +/- SEM (p less than 0.001) after 9 days, and remained normal up to 6 months. Five infants with biochemical liver dysfunction also had normal serum 25 OHD concentrations, indicating the hepatic 25 hydroxylation process was not severely impaired. Serum total and ionized calcium, phosphorus, and vitamin D-binding protein concentrations were normal. Serum magnesium was mildly elevated in five infants (2.6 to 3 mg/dl) on one occasion and resolved spontaneously. Serum alkaline phosphatase (AP) concentrations rose above baseline values in 12 of 17 infants, but remained within normal range (less than 400 IU/liter at 30 degrees C). Another infant with markedly elevated AP values died from liver dysfunction. Radiographs of the forearms were normal except for marked demineralization in one infant in spite of normal 25 OHD concentrations. We conclude that 25 IU vitamin D/dl of nutrient infusate is adequate to maintain normal vitamin D status, as indicated by normal serum 25 OHD concentrations in infants receiving PN for as long as 6 months.