Abstract
Preterm infants are at increased risk of micronutrient deficiencies as a result of low body stores, maternal deficiencies, and inadequate supplementations. The aim of this survey was to investigate current vitamin and mineral supplementation practices and compare these with published recommendations and available evidence on dosages and long-term outcomes of supplementations in preterm infants. In 2018, a two-part electronic survey was emailed to 50 Australasian Neonatal Dietitians Network (ANDiN) member and nonmember dietitians working in neonatal units in Australia and New Zealand. For inpatients, all units prescribed between 400 and 500 IU/day vitamin D, compared to a recommended intake range of 400–1000 IU/day. Two units prescribed 900–1000 IU/day at discharge. For iron, 83% of respondents prescribed within the recommended intake range of 2–3 mg/kg/day for inpatients. Up to 10% of units prescribed 6 mg/kg/day for inpatients and at discharge. More than one-third of units reported routine supplementations of other micronutrients, including calcium, phosphate, vitamin E, and folic acid. There was significant variation between neonatal units in vitamin and mineral supplementation practices, which may contribute to certain micronutrient intakes above or below recommended ranges for gestational ages or birth weights. The variations in practice are in part due to differences in recommended vitamin and mineral intakes between expert groups and a lack of evidence supporting the recommendations for supplementations.
Highlights
Preterm infants are at high risk of micronutrient deficiencies due to maternal deficiencies, low body stores at birth, and low nutritional intakes, such that most preterm infants require vitamin supplementations soon after birth [1]
Whilst similar amounts of vitamins and minerals are generally provided by most commercial preterm nutritional products, individual requirements may vary significantly depending on gestational ages, stores at birth, and clinical factors
Our survey showed that the majority of preterm infants in Australian and New Zealand neonatal units were supplemented with around 400 IU/day of vitamin D, there were wide variations in individual unit supplementation criteria
Summary
Preterm infants are at high risk of micronutrient deficiencies due to maternal deficiencies, low body stores at birth, and low nutritional intakes, such that most preterm infants require vitamin supplementations soon after birth [1]. Nutrients 2020, 12, 51 is met by fortified breast milk and preterm infant formula feeds at enteral feed volumes greater than. Whilst similar amounts of vitamins and minerals are generally provided by most commercial preterm nutritional products, individual requirements may vary significantly depending on gestational ages, stores at birth, and clinical factors. Several international consensus recommendations exist for daily micronutrient intakes for fully enterally fed, stable-growing preterm infants with birth weights up to 1500 g (very low birth weights; VLBWs, Table 1). Similar published recommendations on nutrient intakes are not available for low birth weight (LBW;
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