Enteral Zinc Supplementation and Growth in Extremely-low-birth-weight Infants with Chronic Lung Disease

Overview

Journal J Pediatr Gastroenterol Nutr

Publisher Wiley

Date 2013 Oct 15

PMID 24121149

Citations 10

Authors

Ala K Shaikhkhalil

Jennifer Curtiss

Teresa D Puthoff

Christina J Valentine

Affiliations

Soon will be listed here.

Abstract

Objective: Zinc deficiency causes growth deficits. Extremely-low-birth-weight (ELBW) infants with chronic lung disease (CLD), also known as bronchopulmonary dysplasia, experience growth failure and are at risk for zinc deficiency. We hypothesized that enteral zinc supplementation would increase weight gain and linear growth.

Methods: A cohort of infants was examined retrospectively at a single center between January 2008 and December 2011. CLD was defined as the need for oxygen at 36 weeks postmenstrual age. Zinc supplementation was started in infants who had poor weight gain. Infants' weight gain and linear growth were compared before and after zinc supplementation using the paired t test.

Results: A total of 52 ELBW infants with CLD met entry criteria. Mean birth weight was 682 ± 183 g, and gestational age was 25.3 ± 2 weeks. Zinc supplementation started at postmenstrual age 33 ± 2 weeks. Most infants received fortified human milk. Weight gain increased from 10.9 before supplementation to 19.9 g · kg(-1) · day(-1) after supplementation (P < 0.0001). Linear growth increased from 0.7 to 1.1 cm/week (P = 0.001).

Conclusions: Zinc supplementation improved growth in ELBW infants with CLD receiving human milk. Further investigation is warranted to reevaluate zinc requirements, markers, and balance.

Citing Articles

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A review and guide to nutritional care of the infant with established bronchopulmonary dysplasia.

Miller A, Curtiss J, Taylor S, Backes C, Kielt M J Perinatol. 2022; 43(3):402-410.

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Zinc status and growth in infants and young children with cystic fibrosis.

Bauer S, Lai H, McDonald C, Asfour F, Slaven J, Ren C Pediatr Pulmonol. 2021; 56(12):3768-3776.

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The Role of Nutrition in the Prevention and Management of Bronchopulmonary Dysplasia: A Literature Review and Clinical Approach.

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Staub E, Evers K, Askie L Cochrane Database Syst Rev. 2021; 3:CD012797.

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References

Lowe N, Fekete K, Decsi T . Methods of assessment of zinc status in humans: a systematic review. Am J Clin Nutr. 2009; 89(6):2040S-2051S. DOI: 10.3945/ajcn.2009.27230G. View

Hambidge M . Human zinc deficiency. J Nutr. 2000; 130(5S Suppl):1344S-9S. DOI: 10.1093/jn/130.5.1344S. View

Altigani M, Murphy J, Gray O . Plasma zinc concentration and catch up growth in preterm infants. Acta Paediatr Scand Suppl. 1989; 357:20-33. DOI: 10.1111/j.1651-2227.1989.tb11271.x. View

Atkinson S . Special nutritional needs of infants for prevention of and recovery from bronchopulmonary dysplasia. J Nutr. 2001; 131(3):942S-946S. DOI: 10.1093/jn/131.3.942S. View

Castillo-Duran C, Rodriguez A, Venegas G, Alvarez P, Icaza G . Zinc supplementation and growth of infants born small for gestational age. J Pediatr. 1995; 127(2):206-11. DOI: 10.1016/s0022-3476(95)70296-2. View

Brunton J, Saigal S, Atkinson S . Growth and body composition in infants with bronchopulmonary dysplasia up to 3 months corrected age: a randomized trial of a high-energy nutrient-enriched formula fed after hospital discharge. J Pediatr. 1998; 133(3):340-5. DOI: 10.1016/s0022-3476(98)70266-5. View

Wu F, Wu C . Zinc in DNA replication and transcription. Annu Rev Nutr. 1987; 7:251-72. DOI: 10.1146/annurev.nu.07.070187.001343. View

Berne Y, Carias D, Cioccia A, Gonzalez E, Hevia P . Effect of the diuretic furosemide on urinary essential nutrient loss and on body stores in growing rats. Arch Latinoam Nutr. 2005; 55(2):154-60. View

Shepherd E, Knupp A, Welty S, Susey K, Gardner W, Gest A . An interdisciplinary bronchopulmonary dysplasia program is associated with improved neurodevelopmental outcomes and fewer rehospitalizations. J Perinatol. 2011; 32(1):33-8. DOI: 10.1038/jp.2011.45. View

10.

Valentine C, Fernandez S, Rogers L, Gulati P, Hayes J, Lore P . Early amino-acid administration improves preterm infant weight. J Perinatol. 2009; 29(6):428-32. PMC: 2834366. DOI: 10.1038/jp.2009.51. View

11.

Yeh T, McClenan D, Ajayi O, Pildes R . Metabolic rate and energy balance in infants with bronchopulmonary dysplasia. J Pediatr. 1989; 114(3):448-51. DOI: 10.1016/s0022-3476(89)80569-4. View

12.

Sur D, Gupta D, Mondal S, Ghosh S, Manna B, Rajendran K . Impact of zinc supplementation on diarrheal morbidity and growth pattern of low birth weight infants in kolkata, India: a randomized, double-blind, placebo-controlled, community-based study. Pediatrics. 2003; 112(6 Pt 1):1327-32. DOI: 10.1542/peds.112.6.1327. View

13.

Loui A, Raab A, Wagner M, Weigel H, Gruters-Kieslich A, Bratter P . Nutrition of very low birth weight infants fed human milk with or without supplemental trace elements: a randomized controlled trial. J Pediatr Gastroenterol Nutr. 2004; 39(4):346-53. DOI: 10.1097/00005176-200410000-00009. View

14.

Osendarp S, Santosham M, Black R, Wahed M, van Raaij J, Fuchs G . Effect of zinc supplementation between 1 and 6 mo of life on growth and morbidity of Bangladeshi infants in urban slums. Am J Clin Nutr. 2002; 76(6):1401-8. DOI: 10.1093/ajcn/76.6.1401. View

15.

Tepper R, Morgan W, Cota K, Wright A, Taussig L . Physiologic growth and development of the lung during the first year of life. Am Rev Respir Dis. 1986; 134(3):513-9. DOI: 10.1164/arrd.1986.134.3.513. View

16.

Domellof M, Hemell O, Dewey K, Cohen R, Lonnerdal B . Factors influencing concentrations of iron, zinc, and copper in human milk. Adv Exp Med Biol. 2004; 554:355-8. DOI: 10.1007/978-1-4757-4242-8_40. View

17.

Wastney M, Angelus P, Barnes R, Subramanian K . Zinc kinetics in preterm infants: a compartmental model based on stable isotope data. Am J Physiol. 1996; 271(5 Pt 2):R1452-9. DOI: 10.1152/ajpregu.1996.271.5.R1452. View

18.

Salmenpera L . Detecting subclinical deficiency of essential trace elements in children with special reference to zinc and selenium. Clin Biochem. 1997; 30(2):115-20. DOI: 10.1016/s0009-9120(96)00164-6. View

19.

Fenton T . A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format. BMC Pediatr. 2003; 3:13. PMC: 324406. DOI: 10.1186/1471-2431-3-13. View

20.

Greene H, Hambidge K, Schanler R, Tsang R . Guidelines for the use of vitamins, trace elements, calcium, magnesium, and phosphorus in infants and children receiving total parenteral nutrition: report of the Subcommittee on Pediatric Parenteral Nutrient Requirements from the Committee on.... Am J Clin Nutr. 1988; 48(5):1324-42. DOI: 10.1093/ajcn/48.5.1324. View