Study found little proof that preemies need more vitamin D

Nutrition Support of Neonatal Patients at Risk for Metabolic Bone Disease

A.S.P.E.N. Clinical Guidelines

Deepika Nehra, MD1

Sarah J. Carlson, MD1

Erica M. Fallon, MD1

Brian Kalish, BS1

Alexis K. Potemkin, RN, BSN1

Kathleen M. Gura, PharmD, BCNSP2

Edwin Simpser, MD3

Charlene Compher, PhD, RD, CNSC, LDN, FADA4

Mark Puder, MD, PhD1

the American Society for Parenteral and Enteral Nutrition

1Department of Surgery and The Vascular Biology Program, Children’s Hospital Boston, Harvard Medical School, Boston, Massachusetts

2Department of Pharmacy, Children’s Hospital Boston, Boston, Massachusetts

3St Mary’s Hospital for Children, Bayside, New York

4University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania

Charlene Compher, PhD, RD, CNSC, LDN, FADA, University of Pennsylvania School of Nursing, Claire M. Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19104-4217, USA. Email: compherc@nursing.upenn.edu.

Background: Premature infants are at increased risk for metabolic bone disease, with resulting delayed bone growth, osteopenia, and rickets. Method: A systematic review of the best available evidence to answer a series of questions regarding neonatal patients at risk of metabolic bone disease receiving parenteral or enteral nutrition was undertaken and evaluated using concepts adopted from the Grading of Recommendations, Assessment, Development and Evaluation working group. A consensus process was used to develop the clinical guideline recommendations prior to external and internal review and approval by the American Society for Parenteral and Enteral Nutrition Board of Directors. Questions:

• (1) What maternal risk factors predispose the neonate to metabolic bone disease?

• (2) What is the optimal type of feeding to promote neonatal bone health?

• (3) When and how should vitamin D supplements be administered?

• (4) Does parenteral nutrition (PN) predispose a neonate to metabolic bone disease, and if so, are there PN formulation recommendations to minimize this risk?

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PDF is attached at the bottom of this page

See also VitaminDWiki

• Some preemies needed more than 400 IU of vitamin D – July 2013 not just the 200 IU of the study on this page

• Preemies have low vitamin D levels yet only get 400 IU – July 2013

• Preemies have increased need for vitamin D and Calcium (Rickets)– May 2013

• Many preemies need at least 800 IU of vitamin D – RCT May 2013