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Transient zinc deficiency in a breast-fed premature infant
K M Stapleton1, E O'Loughlin, J P Relic
1Skin and Cancer Foundation Australia, Westmead, New South Wales, Australia.
Insights
A premature infant experienced symptomatic zinc deficiency, presenting with diarrhea and skin rash. Supplementation resolved the condition, highlighting the importance of zinc in infant nutrition.
Area of Science:
- Pediatrics
- Nutritional Science
- Neonatology
Background:
- Zinc deficiency can manifest in exclusively breastfed infants, particularly premature infants with higher nutritional demands.
- Acrodermatitis enteropathica is a genetic disorder of zinc absorption, but acquired zinc deficiency can present similarly.
- Premature infants are at increased risk for micronutrient deficiencies due to immature organ systems and altered absorption.
Observation:
- A 31-week premature male infant presented at 13 weeks of age with diarrhea, irritability, and a rash characteristic of acrodermatitis enteropathica.
- Analysis revealed low zinc concentrations in the mother's breast milk.
- The infant also had concurrent milk protein intolerance, potentially complicating nutritional status.
Findings:
- Symptomatic zinc deficiency was diagnosed in the premature infant.
- Oral zinc supplementation led to the resolution of diarrhea, irritability, and skin eruption.
- Discontinuation of zinc supplementation after 7 weeks showed no recurrence of symptoms.
Implications:
- This case underscores the critical role of adequate zinc levels in breast milk for infant development, especially in premature infants.
- It highlights the importance of considering acquired zinc deficiency in the differential diagnosis of infants presenting with symptoms resembling acrodermatitis enteropathica.
- Early diagnosis and zinc supplementation can effectively manage symptomatic zinc deficiency in vulnerable infant populations.
Abstract:
Symptomatic zinc deficiency developed in a breast-fed premature male infant of 31 weeks gestation. At 13 weeks of age he presented with diarrhoea, irritability and an eruption identical to acrodermatitis enteropathica. Breast milk zinc concentrations were low. His course was complicated by milk protein intolerance. After 7 weeks, zinc supplementation was ceased without recurrence of disease.