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Effect of different vitamin A intakes on very-low-birth-weight infants
W W Koo1, S Krug-Wispe, P Succop
1Department of Pediatrics, University of Tennessee, Memphis, USA.
Insights
Preterm infants fed low-vitamin A formula experienced decreased vitamin A status. Higher vitamin A intakes in preterm infant formula improved vitamin A levels, preventing hyporetinolemia.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Vitamin Metabolism
Background:
- Preterm infants have unique nutritional needs.
- Vitamin A is crucial for infant development and immune function.
- Optimal vitamin A intake for preterm infants requires further investigation.
Purpose of the Study:
- To evaluate the impact of varying vitamin A content in preterm infant formulas on infant vitamin A status.
- To determine the threshold for adequate vitamin A intake in formula-fed preterm infants.
Main Methods:
- Randomized controlled trial involving 61 formula-fed preterm infants (< 1500 g birth weight).
- Infants received formulas with 820, 1640, or 2900 IU/MJ vitamin A.
- Serum retinol and retinol-binding protein (RBP) concentrations were monitored.
Main Results:
- Significantly decreased vitamin A status and hyporetinolemia observed with the lowest vitamin A intake.
- Hyporetinolemia occurred less frequently with intermediate and high vitamin A intakes (P < 0.05).
- No differences in growth or clinical outcomes (e.g., ventilatory support) were observed among groups.
Conclusions:
- Preterm infant formula with low vitamin A content can lead to deficiency.
- Higher vitamin A content in preterm infant formula is recommended to prevent hyporetinolemia.
- Long-term vitamin A status was comparable in infancy regardless of initial formula, suggesting catch-up is possible.
Abstract:
Formula-fed infants with birth weights < or = 1500 g (n = 61) were stratified by 250-g birth-weight ranges and randomly assigned to receive one of three preterm infant formulas (vitamin A contents of 820 IU, 1640 IU, or 2900 IU/MJ; 1 RE = 3.3 IU vitamin A activity) when subjects tolerated 0.314 MJ.kg-1.d-1. Experimental formula feedings were continued until infants weighed approximately 2 kg or until hospital discharge. Vitamin A status as indicated by serum retinol and retinol-binding protein (RBP) concentrations significantly decreased during experimental formula feeding at the lowest vitamin A intake. All subjects fed the formula providing the lowest vitamin A intake had hyporetinolemia (< 0.70 mumol/L, or < 20 micrograms/dL), which occurred less frequently (P < 0.05) with the intermediate (6 of 20) and the high (6 of 21) vitamin A intakes. Other outcome measures, including increases in weight, length, and head circumference, and ventilatory support and oxygen therapy, were not different among groups. After the end of the experimental formula-feeding period, all infants were fed standard infant formulas with a vitamin A content of 715 IU/MJ. In a subset of 19 of these infants, subsequent vitamin A status was monitored at ages 6-12 mo and was found to be comparable with that of older children and adults, regardless of the vitamin A content of the formula fed during hospitalization.(ABSTRACT TRUNCATED AT 250 WORDS)