Zinc Supplementation in Very Low Birth Weight Infants: A Randomized Controlled Trial.

Area of Science:

• Neonatal nutrition
• Pediatric gastroenterology
• Infant immunology

Background:

• Very low birth weight (VLBW) infants have elevated zinc requirements and often experience negative zinc balance.
• Zinc deficiency can impair immune function and gut development in preterm neonates.
• Existing zinc supplementation protocols may not meet the full needs of VLBW infants.

Purpose of the Study:

• To evaluate the impact of high-dose zinc supplementation on feeding intolerance in VLBW infants.
• To assess the effect of increased zinc intake on the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis (LOS).
• To determine the safety and efficacy of higher zinc doses in VLBW preterm infants.

Main Methods:

• A prospective randomized trial involving VLBW infants (gestational age <32 weeks).
• Infants received either regular low-dose zinc (3 mg) or high-dose zinc (9+3 mg) supplementation from day 7 until discharge.
• Outcomes measured included feeding intolerance, NEC (stage ≥2), LOS, and mortality.

Main Results:

• High-dose zinc supplementation led to a significant reduction in feeding intolerance (47.4% vs. 65.3%, p=0.012).
• The incidence of NEC was markedly lower in the high-dose zinc group (1% vs. 11.2%, p=0.003).
• A negative correlation was observed between high-dose zinc and culture-proven LOS episodes (p=0.041), with clinical sepsis also reduced (p=0.029).

Conclusions:

• Elevated zinc supplementation is an effective intervention for VLBW infants, decreasing feeding intolerance, NEC, and LOS.
• The findings support the use of higher-than-regular zinc doses in VLBW infants.
• This higher-dose zinc supplementation strategy appears safe and beneficial for this high-risk neonatal population.