Do Healthy Premature Infants Fed Breast Milk Need Vitamin E Supplementation: α- and γ-Tocopherol Levels in Blood Components and Buccal Mucosal Cells

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Abstract
Prematurely born, low birth weight infants are generally considered to be marginally vitamin E-deficient. Vitamin E deficiency has so far been defined as a low plasma α-tocopherol level (below 500 µg/dL) accompanied by a low tocopherol to lipid ratio or increased hydrogen peroxide hemolysis of erythrocytes. In the present study, we determined α- andγ-tocopherol in plasma, red blood cells, platelets, buccal mucosal cells, monocytes, and polymorphonuclear leukocytes of premature infants to assess vitamin E status. Fourteen healthy, premature infants with birth weight (mean ± SD) 1439 ± 364 g and gestational age 30 ± 1.7 wk were enrolled in the study. α- and γ-tocopherol were determined in cord blood and on d 0 to 1, 7, 14, 28, and 42 after birth in plasma and various cell types. Moreover, two randomly selected human milk samples were studied in each mother. Although subclinical or biochemical vitamin E deficiency was seen in healthy, premature infants in the first 6 wk of life in plasma and buccal mucosal cells, the other cells showed no such deficiency during the study. We conclude that these infants do not need routine vitamin E supplementation.