Vitamins and Minerals: Their Role in Premature Infant Nutrition

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Preterm newborns should get the same amount of vitamin A, vitamin K, thiamin, riboflavin, niacin, pyridoxine, pantothenic acid, vitamins B12, and biotic as full-term infants. An adequate amount of vitamin K should be given to all newborns, both preterm and full-term, upon birth.
When starting enteral feedings, it is advised to start giving the patient a daily multivitamin supplement containing vitamins A, C, D, E, and B complex, at a level equivalent to the NRC-RDA. Please note that folic acid is not included in newborn multivitamins drops. According to the Nutrition Advisory Committee, the recommended dietary allowance for folate (NRC-RDA) can be added to the multivitamin formulation sold in the hospital pharmacy.
Minerals with Vitamins C
Some researchers have reported no detrimental effects of transient neonatal tyrosinemia, but one study reported a lowering of I.Q values in affected children at 7 to 8 years of age, so it’s unclear whether or not preterm infants need high ascorbic acid intakes to improve the activity of hepatic hydroxyphenylpyruvic acid oxidase and reduce blood tyrosine and urinary tyrosine metabolites.
This lack of certainty has led to conflicting advice for taking vitamin C. In 1976, the Nutrition Committee of the Canadian Paediatric Society suggested giving premature infants vitamin C supplements; by 1981, this recommendation had been dropped. Infants born prematurely should take 60 milligrammes of vitamin C daily, as suggested by Zeigler and colleagues. Preterm newborns may need more vitamin C than the 35 mg provided by a daily oral multivitamins, but there is insufficient evidence to warrant a higher supplementation dose, according to the Academy’s Committee on Nutrition.
Vitality Vitamins D
It is unclear whether or not vitamin D insufficiency has a role in the rickets and osteopenia seen in very small preterm newborns. However, other researchers found that preterm infants given a high calcium formula plus 600 to 700 IU Vitamin D per day did show normal serum 25-OH-Vitamin D levels and calcium retentions similar to the foetal retention rate, suggesting that some small preterm infants have a high vitamin D metabolites.
Additional oral calcium and phosphorus and at least 500 IU of vitamin D per day appear to be necessary for the prevention of severe bone damage in premature newborns. The latter can occur when vitamin D is included in the mix. Neither 25-OH-Vitamins D nor 1,25-(OH)2-Vitamin D, the two active Vitamin D metabolites, have been shown to be beneficial or even essential in any clinical trials.
E vitamins
Because of impaired fat absorption, the little premature child has a greater need for vitamin E, alpha-tocopherol, than the term infant. Mild anaemia and mild widespread edoema are symptoms of vitamin E insufficiency in the premature newborn. A high iron intake, which prevents vitamin E absorption and prevents vitamin E-mediated stability of the erythrocyte cell membrane, and a high intake of polyunsaturated fatty acids, which results in a higher vitamin E requirement, both contribute to vitamins E shortage.
At least 0.7 IU of vitamin E (0.5mg of alpha-tocopherol) every 100 kilocalories and 1.0 IU of vitamin E per gramme of linoleic acid is advised. Concerns about the sufficiency of its intestinal absorption have also led to the recommendation that premature infants take 5 to 25 IU of vitamin E supplements daily.
The Benefits of Folic Acid
Laboratory evidence of folate shortage, such as neutrophil hyper-segmentation, is present in many preterm infants, despite the fact that clinical deficit of folic acid is uncommon. Dallman has recommended that premature newborns weighing less than 2000g receive 50ig folate per day since this amount is useful in preventing low serum folate levels after 2 weeks, whereas a daily dose of 20 Uig folate is ineffective. You should know that folic acid is not included in the typical newborn liquid multivitamins solutions.