Recommended Citation
Wilson A, Jones A, Majernik M, Stockdale B, Hu WT. Supplementing With Zinc Aids in Reducing Severe Malnutrition in Preterm Infants. Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Abstract
Background/Significance:
Zinc is an essential micronutrient crucial for various physiological processes such as protein synthesis, gene expression, hormonal regulation, and tissue differentiation. Preterm infants have an increased demand for zinc due to its pivotal role in cellular growth and brain development. Zinc deficiency, even if mild, can impair growth despite sufficient caloric and protein intake. Emerging evidence suggests that subclinical zinc deficiency may elevate the risk of neonatal complications like necrotizing enterocolitis (NEC), bronchopulmonary dysplasia, and retinopathy of prematurity.
Purpose:
This study aims to assess the impact of zinc supplementation on the growth and nutritional status of preterm infants by comparing weight-for-age z-score changes between supplemented and non-supplemented groups.
Methods:
On July 1, 2023, our Level IV NICU implemented a zinc supplementation protocol for preterm infants weighing ≤1250 grams. Eligible infants received 1 mg/kg/day of elemental zinc (zinc sulfate) enterally for 30 days, beginning upon achieving full enteral feeding. We conducted a retrospective cohort study comparing weight-for-age z-score changes from birth to discharge in the supplemented group versus a historical control group. One hundred and two infants received zinc supplementation, with seven excluded due to non-survival, leaving 95 infants for analysis. A randomly selected control cohort of 100 infants from our NICU’s nutrition database was used for comparison. Both groups were similar in gestational age, sex, birth weight, length, head circumference, and discharge anthropometrics. Other factors such as time to initiation of feeds, NEC incidence, breastmilk provision at discharge, postmenstrual age at discharge, and length of stay were also comparable.
Results:
The zinc-supplemented infants achieved full enteral feeds more rapidly, regained birth weight sooner, and required fewer days of total parenteral nutrition and central line use compared to controls. The zinc-supplemented group showed fewer infants with severe growth decline and more infants classified with no or mild/moderate growth decline.
Conclusion:
Zinc supplementation in preterm infants is associated with quicker attainment of goal feeds, faster birth weight recovery, and improved growth trajectories. Although causality cannot be definitively established, these findings suggest that zinc supplementation may have a beneficial impact on growth and development in this vulnerable population.
Presentation Notes
Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Full Text of Presentation
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Document Type
Oral/Podium Presentation
Supplementing With Zinc Aids in Reducing Severe Malnutrition in Preterm Infants
Background/Significance:
Zinc is an essential micronutrient crucial for various physiological processes such as protein synthesis, gene expression, hormonal regulation, and tissue differentiation. Preterm infants have an increased demand for zinc due to its pivotal role in cellular growth and brain development. Zinc deficiency, even if mild, can impair growth despite sufficient caloric and protein intake. Emerging evidence suggests that subclinical zinc deficiency may elevate the risk of neonatal complications like necrotizing enterocolitis (NEC), bronchopulmonary dysplasia, and retinopathy of prematurity.
Purpose:
This study aims to assess the impact of zinc supplementation on the growth and nutritional status of preterm infants by comparing weight-for-age z-score changes between supplemented and non-supplemented groups.
Methods:
On July 1, 2023, our Level IV NICU implemented a zinc supplementation protocol for preterm infants weighing ≤1250 grams. Eligible infants received 1 mg/kg/day of elemental zinc (zinc sulfate) enterally for 30 days, beginning upon achieving full enteral feeding. We conducted a retrospective cohort study comparing weight-for-age z-score changes from birth to discharge in the supplemented group versus a historical control group. One hundred and two infants received zinc supplementation, with seven excluded due to non-survival, leaving 95 infants for analysis. A randomly selected control cohort of 100 infants from our NICU’s nutrition database was used for comparison. Both groups were similar in gestational age, sex, birth weight, length, head circumference, and discharge anthropometrics. Other factors such as time to initiation of feeds, NEC incidence, breastmilk provision at discharge, postmenstrual age at discharge, and length of stay were also comparable.
Results:
The zinc-supplemented infants achieved full enteral feeds more rapidly, regained birth weight sooner, and required fewer days of total parenteral nutrition and central line use compared to controls. The zinc-supplemented group showed fewer infants with severe growth decline and more infants classified with no or mild/moderate growth decline.
Conclusion:
Zinc supplementation in preterm infants is associated with quicker attainment of goal feeds, faster birth weight recovery, and improved growth trajectories. Although causality cannot be definitively established, these findings suggest that zinc supplementation may have a beneficial impact on growth and development in this vulnerable population.
Affiliations
Advocate Children's Hospital, Advocate Christ Medical Center