Vitamin and Mineral Supplementation Practices in Preterm Infants: A Survey of Australian and New Zealand Neonatal Intensive and Special Care Units

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.

Complementary and alternative medicine - practice, attitudes, and knowledge among healthcare professionals in New Zealand: an integrative review

“…Eleven articles met the selection criteria, and were included in this review. Of the nine excluded articles, two were discussion papers [ 23 , 24 ], two reported international studies without data specific to New Zealand [ 25 , 26 ], two reported outcomes irrelevant to this review [ 27 , 28 ], and the remaining three were a review [ 29 ], a commentary [ 30 ], and a letter [ 31 ]. Figure 1 displays the process of study selection.…”

Variation in Neonatal Nutrition Practice and Implications: A Survey of Australia and New Zealand Neonatal Units

“…Survey results discussing variations in vitamin supplementation regimens ( 44 ), dietetic resourcing and written nutrition policies ( 45 ) have been reported elsewhere.…”

Minerals in Pregnancy and Their Impact on Child Growth and Development

“…Even in cases of iron supplementation, brain alterations can be irreversible, especially when iron deficiency is present during phases of neurogenesis and cellular differentiation of the brain areas [32]. Studies also show that in situations of iron deficiency (without gestational anemia), damages can occur to the cellular processes of white cells and in regions of gray matter of the central nervous system, which persist in adult life [31,106].…”

“…Newborns can also receive iron supplementation, but this should be followed on an individual basis; thus, dosages and duration of administration will vary according to the birth weight [106]. Supplementation occurs in specific situations, as the newborn is able to meet iron needs by recycling hemoglobin since breast milk offers a lower iron content [107].…”