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Absorption of high-dose enteral vitamin A in low-birth-weight neonates
A Coutsoudis1, M Adhikari, K Pillay
1Department of Paediatrics and Child Health, University of Natal, Durben.
Insights
High-dose enteral vitamin A supplementation effectively corrects deficiency in low-birth-weight (LBW) neonates. This study found that 25,000 IU doses were well-absorbed and well-tolerated, showing no toxic effects in LBW infants.
Area of Science:
- Neonatal Nutrition
- Pediatric Gastroenterology
- Vitamin Metabolism
Background:
- Vitamin A deficiency is a concern in low-birth-weight (LBW) neonates.
- Assessing the safety and efficacy of high-dose vitamin A supplementation is crucial for this vulnerable population.
Purpose of the Study:
- To evaluate the absorption and tolerance of high-dose enteral vitamin A (25,000 IU) in LBW neonates.
- To determine if supplementation corrects vitamin A deficiency without causing toxicity.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 35 LBW infants (950-1700 g).
- Infants received either placebo or 25,000 IU enteral vitamin A via nasogastric tube on study days 1, 4, and 8.
- Serum retinol levels were measured pre- and post-supplementation; toxic effects were monitored clinically.
Main Results:
- Serum retinol concentrations significantly increased in the vitamin A group compared to placebo (45.77 ± 17.07 vs. 12.88 ± 6.48 µg/dL; P = 0.0001).
- No detectable toxic effects, such as vomiting, drowsiness, irritability, or bulging fontanelle, were observed in any infants.
Conclusions:
- High-dose enteral vitamin A (25,000 IU) is well-absorbed in LBW neonates.
- A regimen of three doses over 8 days is safe and does not induce detectable toxicity in this population.
Abstract:
A randomised, double-blind placebo-controlled trial was designed to determine whether high-dose (25,000 IU) enteral vitamin A, to correct deficiency, would be absorbed and well tolerated in low-birth-weight (LBW) neonates. Thirty-five LBW infants (950-1700 g; gestational age 27-36 weeks) were allocated to receive either placebo or vitamin A (25,000 IU) via nasogastric tube on the first day of the study (between 36 and 60 hours after delivery). The dose was repeated on study days 4 and 8. Serum retinol concentrations were determined pre- and post-supplementation. Toxic effects of vitamin A were monitored by noting vomiting, drowsiness and irritability, and palpating for a bulging fontanelle. The mean serum retinol concentration was significantly higher following supplementation in the vitamin A-treated group than in the placebo group (45.77 +/- 17.07 micrograms/dl v. 12.88 +/- 6.48 micrograms/dl; P = 0.0001). Toxic effects were not detected in any of the infants. In conclusion, high-dose enteral vitamin A is well absorbed in LBW neonates and three doses of 25,000 IU given over a period of 8 days are not associated with any detectable toxic effects.