IN BRIEF

Using Zinc for Growth Delays in NICU Babies

October 21, 2014

A study examining zinc supplementation in extremely low birth-weight infants with chronic lung disease shows promise for improving growth.

Zinc supplementation in extremely low birth-weight (ELBW) infants with chronic lung disease improves weight gain and linear growth, according to a retrospective study performed at Nationwide Children’s Hospital. The study is one of the first to look at the association between zinc supplementation and growth in ELBW babies with chronic lung disease, also known as bronchopulmonary dysplasia.

“Premature infants are born with reduced zinc stores and have high zinc requirements, so they can be at risk for a deficiency,” says Ala Shaikhkhalil, MD, lead author of the paper and a gastroenterologist at Nationwide Children’s. “Zinc is essential for growth and development, but its deficiency can be difficult to diagnose and can be subclinical at times.”

ELBW infants with poor growth trajectories and chronic lung disease (CLD) showed improvement in weight gain and linear growth when they received zinc supplementation in the form of zinc acetate. The study reviewed the medical records of 52 infants at the hospital’s neonatal intensive care unit between 2008 and 2011 who had received zinc supplementation, and findings were published in the Journal of Pediatric Gastroenterology and Nutrition.

“Our study showed that when premature infants who were no longer critically ill but still having trouble gaining weight were given zinc supplementation, their rate of weight gain and their linear growth improved compared to their rates before zinc supplementation,” Dr. Shaikhkhalil says.

Premature infants with CLD are even more likely than other ELBW babies to suffer from growth problems and zinc deficiency, which may be due to an increased metabolic rate or other medical interventions such as the use of the diuretic and steroid therapies, Dr. Shaikhkhalil says.

The infants’ supplementation represented a 100 to 150 percent increase above baseline zinc consumption from a normal intake of human milk or infant formula. Patients included in the review had received supplements for up to 12 weeks. Significant improvements in growth rates were found after just one week of supplementation, and increased linear growth and weight gain remained significant even six weeks after supplementation.

“We need more precise ways to diagnose zinc deficiency,” Dr. Shaikhkhalil says, “but zinc supplementation can certainly be a consideration for premature infants with poor weight gain or poor linear growth.”

If additional research confirms the study’s findings, zinc could potentially become a valuable clinical option for helping physicians improve the growth trajectories of fragile ELBW infants with CLD.

“We have since done a prospective observational study on zinc status to evaluate how it correlates with markers of growth and body composition,” Dr. Shaikhkhalil says. “Next steps would include a randomized trial of zinc supplementation in ELBW infants.”

Join the conversation. When simple supplements, such as zinc, are effective for improving patient outcomes, should they be preferentially prescribed for treatment compared to medications, all other case details being equal?

 

Reference:

Shaikhkhalil AK, Curtiss J, Puthoff TD, Valentine CJ. Enteral zinc supplementation and growth in extremely-low-birth-weight infants with chronic lung disease.Journal of Pediatric Gastroenterology and Nutrition. 2014 Feb;58(2):183-7.