Thiamine, Riboflavin, Folate, and Vitamin B12 Status of Low Birth Weight Infants Receiving Parenteral and Enteral Nutrition

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Abstract
Thirty infants were randomly assigned to receive either 3 mL of MVI-Pediatric supplement (PAR3 group, parenterally fed) or 2 mL (PAR2 group, parenterally fed). For the first week, 100% received total parenteral nutrition (TPN), 50% by the second, and less than 33% by the third. Eighteen control infants received enteral feeds of infant formula. Baseline (before TPN) and subsequent weekly blood samples, dietary data, and 24-hour urine collections were obtained. The adequacies of thiamine and riboflavin were assessed by the thiamine pyrophosphate effect and erythrocyte glutathione reductase activity, respectively. Urinary thiamine and riboflavin levels were measured by fluorometry. Plasma folate, red blood cell folate, urinary folate, and plasma vitamin B 12 concentrations were determined by radioassay. No differences between groups were observed in thiamine pyrophosphate effect, erythrocyte glutathione reductase activity, urinary B1 or Bz, or red blood cell folate levels at any time. Plasma folate differed (p < .05) among the PAR3 group (24 ± 7 ng/mL), and both the PAR2 (13 ± 5 ng/mL) and enterally fed (ENT) groups (16 ± 3 ng/mL) before the initiation of feeds, at week 1 (PAR3 = 32 ± 15 ng/mL; PAR2 = 18 ± 4 ng/mL; ENT = 19 ± 9, ng/mL) and between the PAR3 (30 ± 16 ng/mL) and PAR2 (16 ± 4 ng/ mL) infants at week 2. Plasma vitamin B12 levels differed among the ENT groups (551 ± 287 pg/mL) and both the parenteral groups (PAR2 = 841 ± 405 pg/mL; PAR3 = 924 ± 424 pg/mL) at week 1 and between the ENT (530 ± 238 pg/ mL) and PAR3 (999 ± 425 pg/mL) groups at week 2. From the results of the present study it appears that 2 mL of MVI-Pediatric supplement is sufficient to meet the thiamine, riboflavin, folate, and vitamin B12 needs of the low birth weight infant receiving short-term parenteral nutrition. (Journal of Parenteral and Enteral Nutrition 16:241-247, 1992)