Projected Versus Actual Vitamin D Intake in Premature Infants

Objective: Premature infants are routinely supplemented with Vitamin D, though there are disparate dosing recommendations and fundamental physiological questions regarding its role in this population. Due to the complexity of feeding preterm infants, including adapting to illness, NPO (nothing per os) periods, milk fortification, and transitioning between feeding modalities; we undertook an exercise to model predicted and actual Vitamin D intake for premature infants at various weights. We hypothesized that these projected values would qualitatively differ from actual vitamin D intake data. Study Design: Projected vitamin D intake values for breastfed and formula fed infants were calculated at various birth weights according to our nursery’s typical feeding guidelines, and then compared to actual intake data for four “typical” breastfed premature infants. (n=4) Results: Vitamin D intake ranged throughout the first month, though at full enteral feeds varied between ~400-800 IU/day; a value generally within recommended parameters appearing in the literature. Conclusions: Both the skeletal and non-skeletal effects of vitamin D in premature infants are not well understood. Premature infants are a population with unique vitamin D requirements and often complex feeding regimens during the first few months of life. While currant feeding guidelines will likely result in Vitamin D doses within safe levels, our study demonstrates that actual premature infants often receive less than recommended doses, especially in the first few weeks of life.