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

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

doi:10.1002/14651858.cd012797

Cited by 15 publications

(11 citation statements)

References 38 publications

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“…A small number of studies suggest an intake of at least 1.4–2 mg/kg/d is needed to achieve optimal growth in preterm infants (125,126) but higher enteral intakes appear safe and may be beneficial. Two recent meta‐analyses suggests that zinc supplementation improves weight gain and linear growth in preterm infants and may decrease mortality (127,128). Very preterm infants can develop symptomatic zinc deficiency with acrodermatitis enterohepatica and/or poor growth, especially those infants who have an enterostomy after NEC surgery (129).…”

Section: Trace Elements (See Supplementary Digital Content Supplement...mentioning

confidence: 99%

Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts

Embleton

Moltu

Lapillonne³

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

130

156

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Objectives: To review the current literature and develop consensus conclusions and recommendations on nutrient intakes and nutritional practice in preterm infants with birthweight <1800 g. Methods: The European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee of Nutrition (CoN) led a process that included CoN members and invited experts. Invited experts with specific expertise were chosen to represent as broad a geographical spread as possible. A list of topics was developed, and individual leads were assigned to topics along with other members, who reviewed the current literature. A single face-to-face meeting was held in February 2020. Provisional conclusions and recommendations were developed between 2020 and 2021, and these were voted on electronically by all members of the working group between 2021 and 2022. Where >90% consensus was not achieved, online discussion meetings were held, along with further voting until agreement was reached. Results: In general, there is a lack of strong evidence for most nutrients and topics. The summary paper is supported by additional supplementary digital content that provide a fuller explanation of the literature and relevant physiology: introduction and overview; human milk reference data; intakes of water, protein, energy, lipid, carbohydrate, electrolytes, minerals, trace elements, water soluble vitamins, and fat soluble vitamins; feeding mode including mineral enteral feeding, feed advancement, management of gastric residuals, gastric tube placement and bolus or continuous feeding; growth; breastmilk buccal colostrum, donor human milk, and risks of cytomegalovirus infection; hydrolyzed protein and osmolality; supplemental bionutrients; and use of breastmilk fortifier. Conclusions: We provide updated ESPGHAN CoN consensus-based conclusions and recommendations on nutrient intakes and nutritional management for preterm infants

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Section: Trace Elements (See Supplementary Digital Content Supplement...mentioning

confidence: 99%

Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts

Embleton

Moltu

Lapillonne³

et al. 2022

Journal of Pediatric Gastroenterology &Amp; Nutrition

130

156

View full text Add to dashboard Cite

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“…14,15,29 Studies that evaluated serum zinc levels and the effects of supplementation in clinical outcomes such as growth 7,18,19 and development 15,18 in preterm infants after hospital discharge show divergent results. [30][31][32] These publications included moderate or late preterm infants with younger age and lower breastfeeding rates than our study.…”

Section: Discussionmentioning

confidence: 98%

Association of serum and erythrocyte zinc levels with breastfeeding and complementary feeding in preterm and term infants

Azevedo-Silva

Vivi²,

Fonseca³

et al. 2022

J Dev Orig Health Dis

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Zinc is an important nutrient involved in cell division, physical growth, and immune system function. Most studies evaluating the nutritional status related to zinc and prematurity were conducted with hospitalized preterm infants. These studies show controversial results regarding the prevalence of deficiency, clinical implications, and the effect of zinc supplementation on mortality, infectious diseases, and growth in these groups. This study aimed to compare serum and erythrocyte zinc levels in a group of preterm and full-term infants after 9 months of age, and related the zinc levels to dietary intake and anthropometric indicators in both groups. This cross-sectional study compared 43 preterm infants (24 to 33 weeks) aged 9–24 months to 47 full-term healthy infants. Outcome measures: anthropometric indicators and dietary intake. Blood sample for serum and erythrocyte zinc levels (ICP-MS, Inductively Coupled Plasma Mass Spectrometry). There was no difference between the groups regarding the mean of serum and erythrocyte zinc. Variables associated with higher serum zinc levels were breastfeeding at evaluation (β = 20.11 µg/dL, 95% CI 9.62–30.60, p < 0.001) and the later introduction of solid foods (β = 6.6 µg/dL, 95% CI 5.3–11.4, p < 0.001). Breastfeeding was also associated with higher erythrocyte zinc levels. The zinc levels were adequate in both groups, there was no association with anthropometric indicators or dietary intake and were slightly influenced by breastfeeding and time of solid food introduction.

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“…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/mineralsmentioning

confidence: 99%

“…Zinc is an essential micronutrient for growth, cell proliferation, wound healing, and tissue maintenance 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.…”

Section: Trace Elements/mineralsmentioning

confidence: 99%

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

Cited by 15 publications

References 38 publications

Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts

Enteral Nutrition in Preterm Infants (2022): A Position Paper From the ESPGHAN Committee on Nutrition and Invited Experts

Association of serum and erythrocyte zinc levels with breastfeeding and complementary feeding in preterm and term infants

Select micronutrients for the preterm neonate

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