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Fat-soluble vitamins in breast-fed preterm and term infants

European Journal of Clinical Nutrition volume 60, pages 756–762 (2006)Cite this article

Abstract

Objective:

To examine the supply and status of fat-soluble vitamins in very low birth weight (VLBW) infants compared to a reference group of normal birth weight (NBW) infants.

Design:

A longitudinal study of VLBW infants in the early neonatal period. Blood samples were drawn at 1 week of age and at discharge from hospital. Plasma was analyzed for the fat-soluble vitamins: retinol, 25-OH-vitamin D, α-tocopherol and phylloquinone (vitamin K1) using high-performance liquid chromatography.

Subjects:

A total of 40 VLBW infants were included in the study. A reference group of 33 NBW infants was randomly selected from one of our previous studies.

Results:

The VLBW infants received fortified human milk, and daily oral vitamin supplement (Multibionta). In VLBW infants, plasma retinol concentrations decreased and plasma 25-OH-vitamin D increased during the study period. VLBW infants had significantly lower plasma retinol (0.3 vs 0.7 μ M) and higher plasma 25-OH-vitamin D (166 vs 25 nM) at discharge compared to NBW infants. Plasma phylloquinone concentration in VLBW infants was very high (53 ng/ml) at one week of age, especially in the youngest infants (192 ng/ml), but decreased rapidly during the study period resulting in low/normal plasma concentrations (0.9 ng/ml) at discharge.

Conclusions:

We observed alterations in plasma concentration of retinol and 25-OH-vitamin D in VLBW infants in the early neonatal period, resulting in marked differences between VLBW at discharge and NBW. Further trials are needed to evaluate whether changes in vitamin supplementation may improve clinical outcome in VLBW infants.

Sponsorship:

Norwegian Foundation for Health and Rehabilitation, the Johan Throne Holst Foundation for Nutrition Research and the Research Council of Norway.

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References

  • American Academy of Pediatrics (1998). Pediatric. Nutrition Handbook, 4th edn, Illinois, USA.

  • Azzi A, Stocker A (2000). Vitamin E: non-antioxidant roles. Prog Lipid Res 39, 231–255.

    Article  CAS  Google Scholar 

  • Backstrom MC, Maki R, Kuusela AL, Sievanen H, Koivisto AM, Ikonen RS et al. (1999). Randomised controlled trial of vitamin D supplementation on bone density and biochemical indices in preterm infants. Arch Dis Child Fetal Neonatal Ed 80, F161–F166.

    Article  CAS  Google Scholar 

  • Baydas G, Karatas F, Gursu MF, Bozkurt HA, Ilhan N, Yasar A et al. (2002). Antioxidant vitamin levels in term and preterm infants and their relation to maternal vitamin status. Arch Med Res 33, 276–280.

    Article  CAS  Google Scholar 

  • Bolisetty S, Gupta JM, Graham GG, Salonikas C, Naidoo D (1998). Vitamin K in preterm breastmilk with maternal supplementation. Acta Paediatr 87, 960–962.

    Article  CAS  Google Scholar 

  • Brion L, Bell E, Raghuveer T (2003). Vitamin E supplementation for prevention of morbidity and mortality in preterm infants. Cochrane Database Syst Rev 3, CD003665.

    Google Scholar 

  • Chabra S, Arnold JD, Leslie GI, Bowen JR, Earl J, Wood F (1994). Vitamin A status in preterm neonates with and without chronic lung disease. J Paediatr Child Health 30, 432–435.

    Article  CAS  Google Scholar 

  • Committee on Nutrition of the Preterm Infant ESoPGaN (1987). Nutrition and feeding of preterm infants. Acta Paediatr Scand Suppl 336, 1–14.

  • Costakos DT, Greer FR, Love LA, Dahlen LR, Suttie JW (2003). Vitamin K prophylaxis for premature infants: 1 mg versus 0.5 mg. Am J Perinatol 20, 485–490.

    Article  Google Scholar 

  • Darlow BA, Graham PJ (2002). Vitamin A supplementation for preventing morbidity and mortality in very low birthweight infants. Cochrane Database Syst Rev 4, CD000501.

    Google Scholar 

  • de Pee S, Dary O (2002). Biochemical indicators of vitamin A deficiency: serum retinol and serum retinol binding protein. J Nutr 132 (Suppl 9), 2895S–2901S.

    Article  CAS  Google Scholar 

  • Delvin EE, Salle BL, Claris O, Putet G, Hascoet JM, Desnoulez L et al. (2005). Oral vitamin A, E and D supplementation of pre-term newborns either breast-fed or formula-fed: a 3-month longitudinal study. J Pediatr Gastroenterol Nutr 40, 43–47.

    Article  CAS  Google Scholar 

  • Faerk J, Petersen S, Peitersen B, Michaelsen KF (2000). Diet and bone mineral content at term in premature infants. Pediatr Res 47, 148–156.

    Article  CAS  Google Scholar 

  • Greer FR (1999). Vitamin K status of lactating mothers and their infants. Acta Paediatr Suppl 88, 95–103.

    Article  CAS  Google Scholar 

  • Greer FR (2001). Fat-soluble vitamin supplements for enterally fed preterm infants. Neonatal Networks 20, 7–11.

    Article  CAS  Google Scholar 

  • Greer FR, Mummah-Schendel LL, Marshall S, Suttie JW (1988). Vitamin K1 (phylloquinone) and vitamin K2 (menaquinone) status in newborns during the first week of life. Pediatrics 81, 137–140.

    CAS  PubMed  Google Scholar 

  • Haga P, Lunde G (1978). Selenium and vitamin E in cord blood from preterm and full term infants. Acta Paediatr Scand 67, 735–739.

    Article  CAS  Google Scholar 

  • Harrison EH, Hussain MM (2001). Mechanisms involved in the intestinal digestion and absorption of dietary vitamin A. J Nutr 131, 1405–1408.

    Article  CAS  Google Scholar 

  • Helland IB, Smith L, Saarem K, Saugstad OD, Drevon CA (2003). Maternal supplementation with very-long-chain n-3 fatty acids during pregnancy and lactation augments children's IQ at 4 years of age. Pediatrics 111, e39–e44.

    Article  Google Scholar 

  • Hey E (2003). Vitamin K – what, why, and when. Arch Dis Child Fetal Neonatal Ed 88, F80–F83.

    Article  CAS  Google Scholar 

  • Hustead VA, Gutcher GR, Anderson SA, Zachman RD (1984). Relationship of vitamin A (retinol) status to lung disease in the preterm infant. J Pediatr 105, 610–615.

    Article  CAS  Google Scholar 

  • Inder TE, Graham PJ, Winterbourn CC, Austin NC, Darlow BA (1998). Plasma vitamin A levels in the very low birthweight infant--relationship to respiratory outcome. Early Hum Dev 52, 155–168.

    Article  CAS  Google Scholar 

  • Kumar D, Greer FR, Super DM, Suttie JW, Moore JJ (2001). Vitamin K status of premature infants: implications for current recommendations. Pediatrics 108, 1117–1122.

    Article  CAS  Google Scholar 

  • Markestad T, Aksnes L, Finne PH, Aarskog D (1984). Plasma concentrations of vitamin D metabolites in premature infants. Pediatr Res 18, 269–272.

    Article  CAS  Google Scholar 

  • Roman E, Fear NT, Ansell P, Bull D, Draper G, McKinney P et al. (2002). Vitamin K and childhood cancer: analysis of individual patient data from six case-control studies. Br J Cancer 86, 63–69.

    Article  CAS  Google Scholar 

  • Saxena SP, Israels ED, Israels LG (2001). Novel vitamin K-dependent pathways regulating cell survival. Apoptosis 6, 57–68.

    Article  CAS  Google Scholar 

  • Shaw, Lawson (eds) (2001). Clinical Paediatric Dietetics. Blackwell Science: Oxford.

    Book  Google Scholar 

  • Shearer MJ, Rahim S, Barkhan P, Stimmler L (1982). Plasma vitamin K1 in mothers and their newborn babies. Lancet 2, 460–463.

    Article  CAS  Google Scholar 

  • Shenai JP (1999). Vitamin A supplementation in very low birth weight neonates: rationale and evidence. Pediatrics 104, 1369–1374.

    Article  CAS  Google Scholar 

  • Shenai JP, Chytil F, Stahlman MT (1985). Vitamin A status of neonates with bronchopulmonary dysplasia. Pediatr Res 19, 185–188.

    Article  CAS  Google Scholar 

  • Shenai JP, Chytil F, Jhaveri A, Stahlman MT (1981). Plasma vitamin A and retinol-binding protein in premature and term neonates. J Pediatr 99, 302–305.

    Article  CAS  Google Scholar 

  • Shils ME (1999). Modern Nutrition in health and disease. Williams & Wilkins: Baltimore.

    Google Scholar 

  • Vieth R (1999). Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 69, 842–856.

    Article  CAS  Google Scholar 

  • Wardle SP, Hughes A, Chen S, Shaw NJ (2001). Randomised controlled trial of oral vitamin A supplementation in preterm infants to prevent chronic lung disease. Arch Dis Child Fetal Neonatal Ed 84, F9–F13.

    Article  CAS  Google Scholar 

  • Weber P (2001). Vitamin K and bone health. Nutrition 17, 880–887.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Drs Per Arne Tølløfsrud, Rønnaug Solberg and Alf Meberg for their participation in the study. We also thank the staff at Rikshospitalet University Hospital, bioengineer Louise Tunge and her colleagues for collecting blood samples from the infants. The study was financially supported by the Norwegian Foundation for Health and Rehabilitation, the Johan Throne Holst Foundation for Nutrition Research and the Research Council of Norway.

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Authors and Affiliations

  1. Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway

    C Henriksen, P O Iversen & C A Drevon

  2. Department of Pediatrics, Rikshospitalet University Hospital, Oslo, Norway

    I B Helland, A Rønnestad & M Grønn

Authors
  1. C Henriksen
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  2. I B Helland
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  3. A Rønnestad
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  4. M Grønn
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  5. P O Iversen
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  6. C A Drevon
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Corresponding author

Correspondence to C A Drevon.

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Guarantor: CA Drevon.

Contributors: CH had primary responsiblity for protocol development, patient enrollment, data analysis and writing the manuscript. AR and MG participated in the development of the protocol and analytical framework for the study and contributed to the writing of the manuscript. IBH contributed in the same ways as AR and MG and was responsible for patient enrollment of NBW infants. POI and CAD supervised the design and execution of the study, performed the final data analyses and contributed to the writing of the manuscript.

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Henriksen, C., Helland, I., Rønnestad, A. et al. Fat-soluble vitamins in breast-fed preterm and term infants. Eur J Clin Nutr 60, 756–762 (2006). https://doi.org/10.1038/sj.ejcn.1602379

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602379

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