Infant vitamin

Vitamin B6 1.5-2 mg/day 0.4 mg/day for infants. Vitamin B6 is widely distributed in foods, and symptoms of severe deficiency are seldom observed. However, a number of cases of convulsions have been attributed to partial destruction of vitamin B6 in infant liquid milk formulas. Convulsions occurred when the vitamin B6 content was reduced to about one-half that normally present in human milk. 

Heiskanen K, Salmenpera L, Perheentupa J, Siimes MA. Infant vitamin B-6 status changes with age and with formula feeding. Am J Clin Nutr 1994 60(6) 907-10. 

For these reasons alone, a vitamin E symposium will not be short of problems and material for discussion. Many more unanswered questions come to light, however, when the biochemical and physiological properties of vitamin E are considered. The program of this meeting includes papers on the metabolism of vitamin E interrelations among vitamin E, metals, and ubi( uinones vitamin E and nucleic acid metabolism interrelations between vitamin E and polyunsaturated fatty acids vitamin E requirements of human infants vitamin E in health and disease of poultry, sheep, cattle, and pigs and so on. Everywhere, alongside established facts, there are unanswered questions and unsolved problems. 

The symptom of vitamin K deficiency is increased risk of haemorrhage, ease of bruising, nose bleeding and blood in the urine. In infants, vitamin K deficiency may result in intracranial bleeding. Vitamin K deficiency is rare in adults although vitamin K status is assessed in the newborn and in the USA a routine injection of vitamin K is recommended for newborn babies, particularly premature babies where the vitamin K cycle may not be fidly established. Human breast milk is relatively low in vitamin K. There has been some controversy over whether or not childhood leukaemia can be linked to injection of newborns with vitamin K, but a large retrospective study fotmd no link. Certain dmgs such as warfarin, sulphona-mides and cephalosporins can affect vitamin K function. 

Infants maybe sensitive to doses of vitamin A [11103-57-4] in the range of 75,000—200,000 lU (22.5—60 mg), although the toxic dose in adults is probably 2—5 million lU (90.6—1.5 g). Intakes in this range from normal food suppHes without oral supplements are simply beyond imagination (79). Vitamin D [1406-16-2] toxicity is much more difficult to substantiate clinically. Humans can synthesize active forms of the vitamin in the skin upon irradiation of 7-dehydrocholesterol. Toxic symptoms are relatively nonspecific, and dangerous doses seem to He in the range of 1000—3000 lU/kg body wt (25—75 flg/kg body wt) (80). Cases of toxicity of both vitamins E and K have been reported, but under ordinary circumstances these vitamins are considered relatively innocuous (81). 

Of the water-soluble vitamins, intakes of nicotinic acid [59-67-6] on the order of 10 to 30 times the recommended daily allowance (RE)A) have been shown to cause flushing, headache, nausea, and moderate lowering of semm cholesterol with concurrent increases in semm glucose. Toxic levels of foHc acid [59-30-3] are ca 20 mg/d in infants, and probably approach 400 mg/d in adults. The body seems able to tolerate very large intakes of ascorbic acid [50-81-7] (vitamin C) without iH effect, but levels in excess of 9 g/d have been reported to cause increases in urinary oxaHc acid excretion. Urinary and blood uric acid also rise as a result of high intakes of ascorbic acid, and these factors may increase the tendency for formation of kidney or bladder stones. AH other water-soluble vitamins possess an even wider margin of safety and present no practical problem (82). 

Vitamin Deficiency. Vitamin deficiency is uncommon in normal adults. However, when it does occur, it can be serious, particularly in pregnant women. Some vitamin deficiency can occur because of a large reduction of fat intake, which decreases absorption. Strict vegetarians also risk reduced vitamin intake. Premature infants and elderly people who are exposed to minimal sunlight and consume Htde vitamin also have a reduced capacity to metabolize and can develop vitamin deficiency. 

People who experience the exclusion of sunlight (living in northern climates cultures where apparel limits sunlight), as weU as infants and children that are confined to bed or limited outdoor activity because of weather or illness, also can show a tendency towards vitamin deficiency. 

The symptoms of vitamin E deficiency in animals are numerous and vary from species to species (13). Although the deficiency of the vitamin can affect different tissue types such as reproductive, gastrointestinal, vascular, neural, hepatic, and optic in a variety of species such as pigs, rats, mice, dogs, cats, chickens, turkeys, monkeys, and sheep, it is generally found that necrotizing myopathy is relatively common to most species. In humans, vitamin E deficiency can result from poor fat absorption in adults and children. Infants, especially those with low birth weights, typically have a vitamin E deficiency which can easily be corrected by supplements. This deficiency can lead to symptoms such as hemolytic anemia, reduction in red blood cell lifetimes, retinopathy, and neuromuscular disorders. 

Owing to the ubiquitous natural occurrence of vitamin K and its production by intestinal bacteria, vitamin K deficiencies are rare. However, they can be caused by certain antibiotics (qv) coupled with a reduced dietary intake. Newborn infants who do not possess the necessary intestinal bacterial population are at danger for vitamin K deficiency. As a result, vitamin K injections are routinely given to the newborn. 

In all fermented foods, microbes contribute as preservatives, ie, by lowering the pH and producing ethanol, or by making the food more palatable. The dehberate use of yeasts as food in themselves is less common. Small beer, the sediment from beer, has been traditionally used as a vitamin supplement for infants. Beginning in 1910, dried, spent brewers yeast was developed as a food, and Candida utilis was used as a food supplement in Germany during World War II. 

The world market for ch oline chloride used in animal feeds is estimated at 113,000 t on a 100% basis. The market for good grade ch oline chloride is a small market by comparison and is utilized mainly in the supplementation of infant formulas. Other ch oline salts are utilized solely in the human vitamin supplementation markets and are also small compared to animal feed usage. 

As the above mentioned studies with high supplementation dosages exemplarily show, there is no known toxicity for phylloquinone (vitamin Kl), although allergic reactions are possible. This is NOT true for menadione (vitamin K3) that can interfere with glutathione, a natural antioxidant, resulting in oxidative stress and cell membrane damage. Injections of menadione in infants led to jaundice and hemolytic anemia and therefore should not be used for the treatment of vitamin K deficiency. 

The bile acid sequestrants are contraindicated in patients with known hypersensitivity to the drugs. Bile acid sequestrants are also contraindicated in those with complete biliary obstruction. These drags are used cautiously in patients with a history of liver or kidney disease Bile acid sequestrants are used cautiously during pregnancy (Pregnancy Category C) and lactation (decreased absorption of vitamins may affect the infant). 

Camitine deficiency can occur particularly in the newborn—and especially in preterm infants—owing to inadequate biosynthesis or renal leakage. Losses can also occur in hemodialysis. This suggests a vitamin-fike dietary requirement for carnitine in some individuals. Symptoms of deficiency include hypoglycemia, which is a consequence of impaired fatty acid oxidation and hpid accumulation with muscular weakness. Treatment is by oral supplementation with carnitine. 

Some infants are sensitive to intakes of vitamin D as low as 50 ig/d, resulting in an elevated plasma concen-... 

In experimental animals, vitamin E deficiency results in resorption of femses and testicular atrophy. Dietary deficiency of vitamin E in humans is unknown, though patients with severe fat malabsorption, cystic fibrosis, and some forms of chronic fiver disease suffer deficiency because they are unable to absorb the vitamin or transport it, exhibiting nerve and muscle membrane damage. Premamre infants are born with inadequate reserves of the vitamin. Their erythrocyte membranes are abnormally fragile as a result of peroxidation, which leads to hemolytic anemia. 

Vitamins and Other Nutrients in Food Matrices see also Section 6.3. Food matrices are available with values assigned for vitamins, carotenoids, fatty acids, cholesterol, natural toxins, veterinary drugs, and hormone residues. The NIST food matrix SRMs for vitamins include coconut oil (SRM 1563), infant formula (SRM 1846), and baby food composite (SRM 2383) (particularly for carotenoids). Fatty acids and cholesterol are the primary analytes of interest in meat homogenate (SRM 1546) and diet... 

Vitamin K is a fat-soluble vitamin cofactor for the activation of factors II, VII, IX, and X in the liver. Almost all neonates are vitamin K-deficient at as a result of (1) insignificant transplacental vitamin K crossover, (2) lack of colonization of the colon by vitamin K-producing bacteria, and (3) inadequate dietary vitamin K intake (especially in breast-fed infants because human milk contains less vitamin K than infant formula or cow s milk). Vitamin K-deficiency bleeding (VKDB) refers to bleeding attributable to vitamin K deficiency within first 6 months of life. It occurs in three general time frames early (0-24 hours), classic (1-7 days), and late (2-12 weeks). Early onset occurs rarely and usually is associated with maternal ingestion of anticonvulsants, rifampin, isoniazid, and warfarin. Classic vitamin K-dependent bleeding usually results from the lack of prophylactic vitamin K administration in... 

Cameron C, Lodes MW and Gershan WM. 2007. Facial nerve palsy associated with serum vitamin A level in an infant with cystic fibrosis. J Cyst Fibros 6 241-243. 

In the pediatric population, the daily dose of elemental iron, administered as iron sulfate, is 3 mg/kg for infants and 6 mg/kg for older children for 4 weeks. If response is seen, iron should be continued for 2 to 3 months to replace storage iron pools. The dose and schedule of vitamin B12 should be titrated according to clinical and laboratory response. The daily dose of folate is 1 to 3 mg. 

Multivitamin products have been formulated to comply with guidelines for adults, children, and infants. These products contain 13 essential vitamins including vitamin K. 

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