Sodium homeostasis in term and preterm neonates. III. Effect of salt supplementation

Area of Science:

• Neonatal Medicine
• Pediatric Nutrition
• Biochemistry

Background:

• Premature infants, particularly those born before 34 weeks gestation, are at risk for electrolyte imbalances.
• Postnatal growth and metabolic disturbances are common challenges in the care of preterm neonates.

Purpose of the Study:

• To investigate the clinical and biochemical effects of sodium supplementation in preterm infants.
• To assess the impact of early postnatal sodium intake on infant growth, weight gain, and electrolyte balance.

Main Methods:

• A comparative study involving 22 preterm infants (gestational age 27-34 weeks) receiving sodium supplementation (4-5 mmol(mEq)/kg/day) from days 4-14 of life.
• Comparison with a control group of 24 unsupplemented infants.
• Monitoring of postnatal weight changes, birth weight regain, sodium and potassium balance, plasma sodium concentrations, and incidence of adverse events.

Main Results:

• Supplemented infants exhibited reduced postnatal weight loss and faster birth weight regain, with sustained improved weight gain.
• Positive sodium and potassium balance were observed in supplemented infants compared to controls.
• Lower incidence of hyponatremia (13.6%) in supplemented infants versus unsupplemented (37.5%).
• No adverse effects such as edema, hypernatremia, circulatory overload, increased patent ductus arteriosus, necrotizing enterocolitis, or intracranial hemorrhage were noted.

Conclusions:

• Dietary sodium supplementation of 4-5 mmol(mEq)/kg/day for the first two postnatal weeks is safe and beneficial for infants born before 34 weeks gestation.
• This supplementation strategy improves growth and biochemical status in preterm infants without causing adverse effects.
• Findings suggest improved mineralocorticoid responsiveness in supplemented infants.