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Plasma and red cell folate values and folate requirements in formula-fed premature infants
Insights
Formula-fed premature infants require higher folic acid intake than previously recommended. Supplementation improved folate levels and growth in some infants, suggesting tailored nutritional strategies are crucial for optimal development.
Area of Science:
- Nutritional science
- Pediatric nutrition
- Biochemistry
Background:
- Premature infants have unique nutritional needs.
- Folate is essential for infant growth and development.
- Current folate recommendations may not be optimal for premature infants.
Purpose of the Study:
- To evaluate the impact of folic acid supplementation on premature infants.
- To determine optimal folate intake for formula-fed premature infants.
- To compare folate status and growth in supplemented versus un-supplemented premature infants.
Main Methods:
- Studied 41 premature infants during their first year of life.
- Divided infants by birth weight and assigned to folic acid supplementation or control groups.
- Compared folate levels and growth parameters with breast-fed term infants.
Main Results:
- Folic acid supplementation normalized plasma and red cell folate concentrations.
- Supplementation led to increased length and weight gain in heavier premature infants (Group B).
- No significant differences in hemoglobin or red blood cell counts were observed.
Conclusions:
- Optimal folate intake for formula-fed premature infants is estimated at 150 nmol/day.
- This recommended intake is higher than previously established.
- Folic acid supplementation is beneficial for growth in some premature infants.
Abstract:
Plasma and red cell folate concentrations (lactobacillus casei activity) and other pertinent blood values have been studied during the 1st year of life in 41 premature infants (mean gestational age 31.6, range 26-35 weeks). They were formula-fed, 48.5 nmol (21 micrograms) folate per 1, from 1 month of age. The infants were divided into two groups according to their birth weights (BW): group A, BW less than or equal to 1750 g and group B, BW greater than 1750 g, respectively. One-half of the infants in each group received an extra 113.5 nmol (50 micrograms) folic acid daily. The premature infants were compared with 35 breast-fed term infants considered to have an optimal folate status. The infants not receiving folic acid supplementation had low plasma and red cell folate concentrations during the first months of life, while those receiving supplementation had values comparable to the breast-fed infants. No significant differences in the gain in weight and increase in length were observed when the folic acid supplemented infants in group A were compared with the non-supplemented infants. However, in the case of group B a significant increase in length and a somewhat greater weight gain were observed for infants with folic acid supplementation in comparison with those not given extra folate. No significant differences were observed between the haemoglobin, RBC and VPRC values in the folic acid supplemented and non-supplemented infants. It is estimated that the optimal folate intake during the first months of life in formula-fed premature infants is about 150 nmol (65 micrograms) per day. This amount is higher than previously recommended. The infants from all groups had a folate intake similar to, or above, the minimal daily requirement needed for erythropoiesis.