Enteral zinc supplementation for prevention of morbidity and mortality in preterm neonates

Staub, Eveline; Evers, Katrina Suzanne; Askie, Lisa

doi:10.1002/14651858.cd012797.pub2

Cited by 19 publications

(12 citation statements)

References 64 publications

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“…74 Absorption occurs in the gastrointestinal (GI) tract, specifically in the duodenum and jejunum. 75 Unlike other nutrients, no functional reserve or store of zinc exists in the human body. Preterm neonates are at higher risk for zinc deficiency because of the rapid extrauterine growth rate following premature birth and because most of the zinc accretion occurs during the third trimester.…”

Section: Trace Elements/minerals Zincmentioning

confidence: 99%

“…78 Preterm neonates should receive 400-500 mcg/kg/ day of parenteral zinc (Table 2). 14 Recommended enteral zinc intake ranges from 1 to 3 mg/kg/day for ELBW infants, 75 with a goal of 2-3 mg/kg/day for adequate zinc retention (Table 2). 5,14 Enteral zinc intake should be given separately from enteral copper because of competition for absorption.…”

Section: Trace Elements/minerals Zincmentioning

confidence: 99%

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Select micronutrients for the preterm neonate

Barbieri,

Cober

2023

Nut in Clin Prac

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If premature neonates are not provided with adequate nutrition, they will quickly become deficient because of increased requirements and a lack of nutrient stores to achieve adequate growth. The provision of many of the recommended micronutrients for pediatric and adult patients is challenging in premature neonates because of the limited data surrounding the true needs of premature neonates and the difficulty in assessing adequate serum levels of these nutrients in this patient population. Parenteral and enteral nutrition shortages further complicate providing adequate micronutrients to premature neonates. This review will discuss select micronutrients and their importance to the preterm neonate, with special emphasis on micronutrients with limited evidence and more challenging supplementation and repletion strategies.

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Section: Trace Elements/minerals Zincmentioning

confidence: 99%

Section: Trace Elements/minerals Zincmentioning

confidence: 99%

Select micronutrients for the preterm neonate

Barbieri,

Cober

2023

Nut in Clin Prac

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“…A Cochrane review of long-chain polyunsaturated fatty acids supplementation in preterms found no proven effect 27. Zinc has also risen to prominence in recent years, with a Cochrane review suggesting that enteral supplementation with zinc is likely to improve growth and reduce mortality 28. This is particularly significant given that commonly available parenteral and enteral nutrition products typically deliver markedly insufficient amounts of zinc (table 1), and zinc deficiency is common in preterm infants 29…”

Section: Establishing Nutritional Requirementsmentioning

confidence: 99%

Optimising growth in very preterm infants: reviewing the evidence

Young

Beattie

Johnson

2022

Arch Dis Child Fetal Neonatal Ed

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Infants born before 32 weeks’ postmenstrual age are at a high risk of growth failure. International guidelines have long recommended that they match the growth of an equivalent fetus, despite the challenges posed by ex utero life and comorbidities of prematurity. Several groups have recently questioned the necessity or desirability of this target, shifting attention to aiming for growth which optimises important long-term outcomes. Specifically, recent research has identified the neurodevelopmental benefits of enhanced growth during the neonatal period, but work in term infant suggests that rapid growth may promote the metabolic syndrome in later life. In this context, defining a pattern of growth which optimises outcomes is complex, controversial and contested. Even if an optimal pattern of growth can be defined, determining the nutritional requirements to achieve such growth is not straightforward, and investigations into the nutritional needs of the very preterm infant continue. Furthermore, each infant has individual nutritional needs and may encounter a number of barriers to achieving good nutrition. This article offers a narrative review of recent evidence for the competing definitions of optimal growth in this cohort. It examines recent advances in the determination of macronutrient and micronutrient intake targets along with common barriers to achieving good nutrition and growth. Finally, key implications for clinical practice are set out and a recommendation for structured multidisciplinary management of nutrition and growth is illustrated.

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“…Additionally, preterm infants are at increased risk of Zn deficiency because of lower stores, secondary to shortened gestational period, and increased requirements [ 22 , 23 ]. According to recently published systematic reviews, Zn supplementation in preterm infants may improve weight gain and linear growth, as well as decrease mortality [ 22 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Growth after implementing a donor breast milk program in neonates <33 weeks gestational age or birthweight <1500 grams: Retrospective cohort study

et al. 2023

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Background Donor breast milk (DBM) feeding has been associated with less growth than formula in preterm infants. Zinc content in DBM is insufficient to support growth in preterm infants. Objective To compare growth from birth to discharge, macro- and micronutrient intake and the frequency of poor growth before (Epoch-1) and after (Epoch-2) implementing a DBM program. Methods Retrospective cohort study of 1069 infants born at < 33 weeks’ gestational age or birthweight < 1500 g and fed using our adjustable feeding protocol with accurate serial length measurements. Growth was assessed by changes in Z-scores of weight, length and fronto-occipital circumference from birth to discharge. Results Growth did not decrease significantly in Epoch-2. However, energy and protein intake increased by 5% and frequency of zinc and vitamin D supplementation increased by >30%. Conclusions DBM implementation did not significantly decrease growth from birth to discharge using our adjustable feeding protocol.

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Enteral zinc supplementation for prevention of morbidity and mortality in preterm neonates

Cited by 19 publications

References 64 publications

Select micronutrients for the preterm neonate

Select micronutrients for the preterm neonate

Optimising growth in very preterm infants: reviewing the evidence

Growth after implementing a donor breast milk program in neonates <33 weeks gestational age or birthweight <1500 grams: Retrospective cohort study

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