Nutritional Value of Vitamins in Premature Infants

The recommended oral intake of vitamins A, K, thiamin, riboflavin, niacin, pyridoxine, pantothenic acid, vitamin B12, and biotic by preterm infants is the same as that recommended for full term infants. All preterm, as well as term infants should receive at least 1mg vitamin K at birth

The International committee on Nutrition recommends that daily multivitamin supplements be given when enteral feedings are established, The most appropriate supplements are those that contain the National Research Council’s recommended Dietary Allowance (NRC-RDA) of vitamins A, C, D, E and B complex. Be aware that liquid multivitamin drops for infants do not contain folic acid. The committee of Nutrition suggests that the NRC-RDA of folate can be added to the multivitamin preparation in the hospital pharmacy.

Vitamin C
There have been conflicting reports on the need for high ascorbic acid intakes in preterm infants to enhance the activity of hepatic hydroxyphenylpyruvic acid oxidase and to lower blood tyrosine and urinary tyrosine metabolites levels, Some investigators have General hashtag linkage to COVID-19 Pandemic reported no detrimental effects of transient neonatal tyrosinemia, but one study reported a lowering of I.Q values at 7 to 8 years of age in affected children.

Due to the uncertainties, there have not been consistent recommendations regarding vitamin C supplementation. Although the Nutrition Committee of the Canadian Paediatric Society recommended Vitamin C supplements for preterm infants in 1976, it did not do so in 1981. Zeigler and co-workers recommended an intake of 60mg vitamin C per day by preterm infants. Due to the absence of compelling evidence for a high vitamin C requirement in preterm infants, the Academy’s Committee on Nutrition does not recommend a supplement in addition to the 35 mg in the daily oral multivitamin mixture.

Vitamin D
The role of vitamin D deficiency in the development of the osteopenia and rickets of small premature infants is uncertain. Although some investigators have suggested that some small premature infants have a high vitamin D metabolites, others have 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 fetal retention rate.

The prevention of severe bone disease in preterm infants appears to rely on both supplemental oral calcium and phosphorus and at least 500IU vitamin D per day. The latter can be achieved by giving vitamin D in the formula. There is no evidence that administration of the active Vitamin D metabolites, 25-OH-Vitamin D or 1,25-(OH)2-Vitamin D, is necessary or advisable.

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