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Vitamin E requirements of preterm infants
Insights
Higher vitamin E supplementation in breast milk fed preterm infants significantly improved hemoglobin levels. Early, low-dose iron supplementation was found to be safe for these infants.
Area of Science:
- Neonatal Nutrition
- Pediatric Hematology
- Vitamin E Metabolism
Background:
- Breast milk-fed preterm infants may have varying nutrient levels.
- Previous studies showed feeding practice differences impacting infant health.
- Accurate alpha-tocopherol quantitation is crucial for assessing vitamin E status.
Purpose of the Study:
- To investigate the effects of different vitamin E dosages on preterm infants.
- To evaluate the safety and efficacy of early iron supplementation in this population.
- To determine optimal supplementation strategies for breast milk-fed preterm infants.
Main Methods:
- Utilized a sensitive technique for serum alpha-tocopherol measurement.
- Compared high-dose (16.5 mg/day) versus low-dose (1.5 mg/day) vitamin E supplementation.
- Administered low-dose iron (2-3 mg Fe++/kg/day) from 3 weeks of age.
Main Results:
- High-dose vitamin E significantly increased hemoglobin and decreased reticulocyte counts in infants <2000g birth weight.
- Low-dose vitamin E (1.5 mg/day) led to subnormal alpha-tocopherol in some infants (2000-2499g birth weight) without affecting hemoglobin.
- Early iron supplementation showed no adverse effects.
Conclusions:
- Extra vitamin E supplementation is recommended for breast milk-fed preterm infants.
- Higher vitamin E doses appear more effective in improving hematological parameters.
- Low-dose iron supplementation is safe and potentially beneficial for preterm infants.
Abstract:
Differences between feeding practices in earlier investigations prompted the present study of iron and vitamin E supplementation in breast milk fed preterm infants. A new and highly sensitive technique for quantitation of alpha-tocopherol in serum was used. Studies on 34 infants with a birth weight below 2000 g or gestational age less than or equal to 35 weeks showed that supplementation with 16.5 mg tocopheryl acetate/day from 10 days of age resulted in a significantly higher haemoglobin concentration and lower reticulocyte count at 8-10 weeks than supplementation with 1.5 mg/day (p is less than 0.05). Studies on 23 infants with a birth weight of 2000-2499 g revealed subnormal alpha-tocopherol levels in 2 of the infants given 1.5 mg tocopheryl acetate/day but there was no effect on the haemoglobin concentration at 8-10 weeks. There were no untoward effects of an early iron supplementation with 2-3 mg Fe++ (as ferrous succinate)/kg/day. It is concluded that extra supplementation with vitamin E is advisable also in breast milk fed preterm infants. A low dosage iron supplementation from 3 weeks of age is safe.