Preterm infants

The European Society of Gastroenterology, Hepatology and Nutrition (ESPGHAN) states that vitamin D nutrition in preterm infants is essential for bone mineralisation and neuromuscular function.

• ESPGHAN 2010 recommends a vitamin D intake of 800 to 1000 IU/day (20-25μg) during the first months of life.⁶
• Koletkzo 2014 recommends that 400 IU/day is sufficient in the presence of adequate calcium, phosphorus and magnesium but if infant stores are low due to poor maternal status, 1000 IU/day is advised.⁷
• These recommendations apply to both premature infants fed breast milk and those fed formula milk.⁶

If a preterm infant is fed a post-discharge formula (PDF) when discharged from hospital, additional vitamin D supplementation may be required depending on the brand of PDF used. This decision should be made in the Neonatal Intensive Care Unit (NICU) by the neonatologist or neonatal dietitian. PDFs contain higher levels of macro and micro nutrients to support the increased growth requirements of the preterm infant.⁸

Once the preterm infant reaches 6 months corrected age, the GP should stop prescribing PDF and the infant should receive either a standard infant formula or follow-on formula supplemented with 200 IU vitamin D daily until their first birthday.

Preterm infants who are discharged from hospital breastfeeding should receive supplements of 400 IU vitamin D once daily until their first birthday. Thereafter, parents should follow government guidelines on vitamin D intake.

Did you know?

80% of minerals are accreted in bone during the third trimester.⁷