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Selenium status of preterm infants: the effect of postnatal age and method of feeding
L Daniels1, R Gibson, K Simmer
1Department of Public Health, Flinders University of South Australia, Australia.
Insights
Preterm infants fed parenteral nutrition (PN) experienced critically low selenium (Se) levels. Enteral feeding with PN did not prevent this decline, highlighting the importance of adequate Se intake for infant health.
Area of Science:
- Nutritional Science
- Pediatric Medicine
- Biochemistry
Background:
- Selenium (Se) is an essential trace element crucial for infant development.
- Preterm infants have unique nutritional requirements due to physiological immaturity.
- Parenteral nutrition (PN) may alter nutrient status in vulnerable infant populations.
Purpose of the Study:
- To assess selenium status in preterm and term infants.
- To investigate the impact of different feeding modalities on plasma Se levels.
- To evaluate erythrocyte glutathione peroxidase (GSHPx) activity as an indicator of Se status.
Main Methods:
- Longitudinal study involving 63 preterm and 46 term infants.
- Measurement of plasma Se levels and erythrocyte GSHPx activity.
- Comparison of Se status based on feeding type: parenteral nutrition, breast milk, and formula.
Main Results:
- Plasma Se levels were similar at birth but declined significantly in preterm infants on PN.
- Enteral feeding alongside PN did not prevent a drop in plasma Se levels.
- Breastfed term infants showed increased plasma Se, while formula-fed term infants did not.
- Erythrocyte GSHPx activity did not correlate well with plasma Se or intake.
Conclusions:
- Feeding type significantly influences plasma Se concentration in preterm infants.
- Parenteral nutrition, even with enteral support, is insufficient to maintain adequate Se levels.
- Preterm infants require careful Se monitoring and optimized nutritional strategies.
Abstract:
Indicators of selenium (Se) status were measured in a longitudinal study of 63 preterm and 46 term infants. Se levels in both groups were similar in the first few days of life. Preterm infants fed parenteral nutrition (PN) for several weeks developed very low plasma Se levels (< 10 micrograms/l). In those receiving either breast milk or formula in conjunction with PN, plasma Se also declined over the first 6 weeks. In the breastfed term infants plasma levels increased by 50%, but there was no increase in the term formula-fed group. In healthy preterm infants who received mainly breast milk, plasma Se concentrations remained constant at newborn levels and were below those of breastfed term infants at 6 weeks. Erythrocyte GSHPx activity did not reflect plasma Se or Se intake. In conclusion, the type of feeding, and hence Se intake, influenced plasma Se concentration in preterm infants. Provision of enteral feeding in conjunction with PN was unable to prevent a decline in plasma Se and at 6 weeks levels were well below those of the reference breastfed term infants.