Very premature infants are called early preterm infants (EPTIs) and are defined as infants born eight or more weeks early. A subset of EPTIs are born 12 weeks or earlier and often weigh less than a pound.
What are the vitamin D levels of such children, how to those levels change from birth to discharge, and how much vitamin D do they actually get during their hospitalization?
These questions have never fully be answered until recently when Doctor Nagendra Monangi, working under senior author Associate Professor Henry Akinbi, both of the Children’s Hospital Medical Center at the University of Cincinnati, conducted the first longitudinal study of vitamin D levels in very premature infants.
Monangi N, Slaughter JL, Dawodu A, Smith C, Akinbi HT. Vitamin D status of early preterm infants and the effects of vitamin D intake during hospital stay. Arch Dis Child Fetal Neonatal Ed. 2013 Jul 13.
Here is what they found:
- Overall, 64% of EPTIs had serum 25(OH)D concentrations <20 ng/ml at birth.
- Approximately 70% of infants born more than 12 weeks premature had 25(OH)D concentrations <20 ng/ml.
- Sixty-three percent of mothers had 25(OH)D concentrations <20 ng/ml.
- Mean vitamin D intake at 4 weeks postnatal age was only 290 IU/day.
- At discharge, 40% of the infants still had intakes less than 400 IU/day.
- Forty percent of infants born more than 12 weeks early still had 25 (OH)D levels <20 ng/ml at discharge.
The authors concluded:
“In this study, neither the vitamin D intake, nor the recommended serum 25(OH)D concentrations of ≥20 ng/ml were attained in many EPTIs. The serum 25(OH)D concentrations of infants were directly correlated with maternal vitamin D status at birth. Therefore, vitamin D status should be optimized in pregnant women as part of strategy to replete the offspring. In addition, EPTIs require heightened attention to vitamin D supplementation in the NICU to improve vitamin D intake and vitamin D status.”
The researchers also noted that while the U.S. Food and Nutrition Board recommends 400 IU/day for all children, no matter their weight, the European Society for Pediatrics Gastroenterology, Hepatology and Nutrition recommend 800–1000 IU/day for preterm infants, an amount that was certainly not being met.