TRACE ELEMENTS IN NEWBORNS AND INFANTS WITH GASTROINTESTINAL AND NUTRITION WITH A SEMIELEMENTAL FORMULA. W.Baumann, S.Wirth, Johannes Gutenberg-University, Luft, K .M. Keller. Department of Pediatrics,
Enteral nutrition of newborns and infants with severe gastrointestinal diseases (CID) is Regarding enteral absorption still a problem. Regular formulas are usually not tolerated. the use of semielemental formulas (SEF) has obvious advantages but supplementation of trace elements is not well established. In a prospective study 20 newborns and infants (1120-4220 g) with CID (necrotizing en13 of them after surgical treatment) were fed terocolitis, gastrointestinal malformations; Nestle; content of trace elements in 15 % solution: iron exclusively with a SEF (Alfare, (Fe) 0,9 mg, copper (Cu) 0,045 mg, magnesium (Mg) 9 mg, zinc (Znl 0,18 mg, manganese (Mn) 5.1 pg, iodine (I) 3.6 pg I 100 ml) during 2-4 months. Monitoring included clinical data and serum levels of Fe, Cu, Mg, Zn, selenium (Se), I and thyroxine (T4), analysed before feeding and after 1, 2, 4, 8 and 12 weeks. Reference group was composed of 35 healthy and normally fed newborns and infants. The SEF was well tolerated. Daily weight gain ranged from 12-38.6 g (x=22,4+7,2) and monthly growth rate was 2,7+0,9 cm. Serum levels of Fe, Cu and T4 were found to be normal. Decreased values were observed for Zn in 13, Se in 12, Mg and I in 2 of the 20 patients. Nestle) is an appropriate diet for enteral nuOur study demonstrates that SEF (Alfare, trition in newborns and infants with severe CID. In contrast to Zn and Se, supplemenTherefore the content of Zn in this SEF tation with Fe, Cu, Mg and I was adequate. should be increased and the addition of Se seems to be necessary. We conclude that all SEF must be supplemented with trace elements considering more the requirements of these patients.
BALANCE STUDIES OF ZINC AND COPPER IN INFANTS RECEIVING TOTAL PARENTERAL NUTRITION (TPN). R. Shulman. Department of Pediatrics, USDA/ARS CNRC, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, U.S.A.
The adequacy of the recommended parenteral intakes of Zn and Cu was studied in 15 infants (x f. SE: 3.1 + 1.1 mo, range 0.25 - 17 mo) who were NPO and who received TPN supplemented with Zn and Cu (100 ug/kg/d and 10 pg/kg/d, respectively) as currently recommended. Zn and Cu serum measurements and 24 hr balances were obtained at baseline, 1, and 2 wk. Results of the Zn and Cu determinations are shown.
Serum Zn tug/d11 Zn balance tug/kg/d) Serum Cu (ug/dl) Cu balance tug/kg/d)
Baseline (n = 15) 61 +5* -0.06; 0.04+ -0.0;:
1 week 67 0.04 100 0.003
(n = 15) +5 +0.02+ 5 8$ -+0.003§
2 weeks (n = 9) 69 +6 0.03 +0.01 100 7 12 0.004 -+ 0.001
NoLmal serum Zn: 52-163 ug/dl; normal serum Cu: 65-145 ug/dl. * X+ SE; +P < 0.10; $P < 0.023; 8 P < 0.057. Serum levels were 5/15, 3/15, and l/9 Y/15, 3/15, and 219 intestinal drainage
low at baseline, 1 and 2 wk for Zn in 4/15, 3/15, and O/Y infants and for Cu in infants, respectively. Balances were negative at baseline, 1 and 2 wk for Zn in infants and for Cu in 7/15, 2/15, and O/Y infants, respectively. Only infants with (i.e., nasogastric, ileostomy) were in negative balance at 1 and 2 wk.
Conclusions: 1) These preliminary data suggest that the recommended parenteral Zn and Cu intakes are adequate for most infants. 2) Infants with intestinal drainage may require supplemental Zn and Cu. 3) Changes in Zn balances were not reflected in serum Zn levels.