Symptomatic zinc deficiency in breast-fed premature infants

We present a case of a transient acquired zinc deficiency in a breast-fed, 4-month-old-male prematurely born infant, with acrodermatitis enteropathica-like symptoms such as crusted, eroded, erythemato-squamous eruption in periorificial and acral patterns. The laboratory investigations showed low zinc levels in the infant’s and the mother’s serum and in the mother’s milk; genetic analysis did not show any mutation in the SLC39A4 gene, involved in acrodermatitis enteropathica. Acquired zinc deficiency is often found in premature infants because of their increased requirement, the low serum and milk zinc levels in breastfeeding women being also an important risk factor, as in this case. A prompt zinc supplementation is essential for the good prognosis of the disease.

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Acrodermatitis in Breast-Fed Premature Infants: Evidence for a Defect of Mammary Zinc Secretion

PEDIATRICS ◽

10.1542/peds.69.2.176 ◽

1982 ◽

Vol 69 (2) ◽

pp. 176-183 ◽

Cited By ~ 1

Author(s):

Andrew W. Zimmerman ◽

K. Michael Hambidge ◽

Martha L. Lepow ◽

Robert D. Greenberg ◽

Mary L. Stover ◽

...

Keyword(s):

Breast Milk ◽

Zinc Deficiency ◽

Premature Infants ◽

Serum Zinc ◽

Zinc Content ◽

Zinc Level ◽

Zinc Intake ◽

Exponential Decline ◽

Zinc Supplements ◽

Breast Fed

Two 9-week-old, breast-fed premature infants developed acrodermatitis and hypozincemia because of low zinc content in their mothers' breast milk. All symptoms of zinc deficiency disappeared within seven days after the infants were treated orally with zinc and did not recur when zinc was discontinued after 11 months (infant 1) and three weeks (infant 3). After a subsequent term pregnancy, one of the mothers had lower breast milk zinc content (P < .025) and greater exponential decline (P < .025) of zinc content through 40 weeks of lactation compared with 34 control subjects. Her second infant (infant 2) had hypozincemia at 7 months of age but did not develop clinical zinc deficiency. When the mothers of the affected infants took oral zinc supplements, there was no increase in their breast milk zinc content. Zinc secretion into breast milk appears to be a controlled process that is independent of maternal zinc intake or serum zinc level. Breast milk may be low in zinc because of defective mammary secretion and this may lead to severe symptomatic zinc deficiency in premature infants.

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Symptomatic zinc deficiency in breast‐fed term and premature infants

Journal of Paediatrics and Child Health ◽

10.1046/j.1440-1754.1998.00164.x ◽

1998 ◽

Vol 34 (1) ◽

pp. 97-100 ◽

Cited By ~ 55

Author(s):

J STEVENS ◽

L LUBITZ

Keyword(s):

Zinc Deficiency ◽

Premature Infants ◽

Breast Fed

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Zinc Deficiency and Edema

PEDIATRICS ◽

10.1542/peds.77.1.132a ◽

1986 ◽

Vol 77 (1) ◽

pp. 132-133

Author(s):

MICHAEL H. N. GOLDEN ◽

BARBARA E. GOLDEN

Keyword(s):

Developing Countries ◽

Zinc Deficiency ◽

Premature Infants ◽

Zinc Concentration ◽

Clinical Presentation ◽

Plasma Zinc ◽

Plasma Zinc Concentration ◽

Clear Association ◽

Zinc Concentrations

To the Editor.— Kumar and Anday1 describe three premature infants presenting with edema and hypoproteinemia—the classical signs of kwashiorkor—between 5 and 9 weeks of age. Such cases are not uncommon in developing countries. Kumar and Anday's patients had low plasma zinc concentrations (43, 37, and 42 µg/dL). On this basis the authors claim that edema and hypoproteinemia is a clinical presentation of zinc deficiency not previously reported. We reported2 a clear association between "nutritional" edema and a low plasma zinc concentration in 1979; our subsequent experience has confirmed that edema of this type is always associated with a low plasma zinc concentration, as indeed Kumar and Andays' cases demonstrate.

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