Parenteral Nutrition and Oral Milk Based Formula in Children

Parenteral Nutrition and Oral Milk Based Formula in Children 

Pediatric patients are particularly at risk for Al neurotoxicity. The development of the brain occurs in the first year of life. High permeability of the immature blood-brain barrier to Al, the increased uptake of Al via a relatively poorly developed gastrointestinal tract, immature formation and function of the kidneys and high Al to body ratios probably all contribute to the Al toxicity [144, 145, 162-165], Children not on dialysis were intoxicated by Al-containing phosphate binders and developed encephalopathy [78, 162, 164, 166, 167], 

A study of newborn and premature infants found that the intake from milk and formulas for preterm infants is about 0.03 mg Al/day [168, 169]. Several cases were reported to develop neurological symptoms with elevated Al tissue levels receiving no dialysis and no Al-containing phosphate binders, but Al-containing milk based formula [165, 170], The Al content of breast milk is very small (about 20 pg/L), and formulas based on cow s milk contain about ten times as much Al. The highest amount of Al have been reported from soya-based formulas for lactose intolerance (200 pg/L to 1000 pg/L), but its toxicity risk is unknown [171, 172], 

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