Zinc is essential for growth and normal function of skin and intestine.
Mature infants should receive 400 mcg/kg/day. Term infants under 3 months of
age should receive 250 mcg/kg/day, and term infants over 3 months of age
should receive 100 mcg/kg/day. In patients with high volume gastrointestinal
losses from stomas or diarrhea, administration of more than 400 mcg/kg/day may
be needed regardless of the patients’ age.
Trace elements are essential because lack of these nutrients leads to
specific symptoms. Deficits of zinc cause acrodermatitis enteropathica, which is
characterized by dermatitis, glossitis, alopecia, and diarrhea. Chromium deficits
produce hyperglycemia. Copper deficits may present as an anemia that is not
responsive to iron administration.
Carnitine is a co-factor for the transport of long chain fatty acids into
mitochondria and some studies suggest that it is an essential co-factor in infancy.
Premature infants can develop a deficiency of carnitine stores within one week.
L-Carnitine at 5-10 mg/kg/day should be added to the parenteral nutrition of
neonates.
Multivitamins should be provided on a daily basis by weight. Patients
under 1000 grams should receive 1 mL, 1000-1500 grams should receive 2 mLs,