Minerals, Trace Elements, and Vitamins
Posted by Surgery on Sep 9, 2008
Rapidly growing infants need more minerals than do mature adults. This is especially true of phosphorus and calcium because of the exceptional rate of skeletal growth in infants and children.
The ash content, reflecting mineral composition, of the fetus is low and at birth constitutes only 3% of body weight. It increases continuously throughout childhood, both absolutely and relatively. The mineral content in adults is 40 times greater than in newborns, whereas the body weight is only 23 times greater (12:Norvasc). Due to the intrinsic difficulty formulating a solution with both calcium and phosphate, conventional parenteral nutrition in VLBW infants will fail to deliver adequate amounts of these minerals for bone growth.
Trace elements comprise less than 0.01% of the total body weight in humans. They typically function as metalloenzymes, maximizing enzymic reactions. They may also act as soluble ionic cofactors or nonprotein organic molecules. Vitamins are essential components or cofactors for various metabolic reactions. All commercial infant formulas contain adequate amounts of vitamins to meet normal daily requirements. Recommendations for normal daily requirements of vitamins have been recently revised by the U.S. Food and Drug Administration (13:Norvasc).
ENTERAL NUTRITION
Enteral nutrition (EN) includes oral nutritional supplementation and tube feedings. EN should be the primary source of nutrients if the gastrointestinal tract is functional. Even when full feedings are not tolerated enterally, the provision of small volumes of trophic feedings may prevent further deterioration of intestinal function.
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