Sodium homeostasis in term and preterm neonates. III. Effect of salt supplementation.

Abstract

SUMMARY Clinical and biochemical effects of supplementing dietary sodium intake to 4 to 5 mmol(mEq)/kg/day from days 4 to 14 of life were studied in 22 infants of gestational age 27 to 34 weeks. These infants were compared with a group of 24 unsupplemented babies. Supplemented infants lost less weight postnatally and regained birthweight more quickly: their improved weight gain continued after supplementation was stopped. Sodium balance was positive at age 5 to 11 days in supplemented babies but slightly negative in controls. Potassium balance was more strongly positive in the supplemented group. Plasma sodium concentration was higher in supplemented infants during weeks 3 and 4. Hyponatraemia was signficantly more common in unsupplemented (37-5%) than supplemented (13-6%) infants. No infant became oedematous, hypernatraemic, or showed evidence of circulatory overload. The incidence of patent ductus arteriosus and necrotising enterocolitis was not increased; no intracranial haemorrhages occurred. Urinary potassium:sodium ratio was lower in supplemented babies than controls suggesting responsiveness of the distal tubule to mineralocorticoids. Providing 4 to 5 mmol(mEq)/kg/day of sodium to infants born before 34 weeks' gestation for the first two postnatal weeks improves growth and biochemical status and causes no undesirable side effects.We have previously shown that preterm babies of less than 35 weeks' gestation have high renal and intestinal sodium losses during the first two weeks of life, leading to negative sodium balance and hyponatraemia (plasma sodium less than 130 mmol(mEq)/l) in many. 2 We concluded that increasing dietary sodium intake to 4 mmol(mEq)/ kg/day for infants of gestational age 31 to 34 weeks and 5 mmol(mEq)/kg/day for infants of less than 31

Salt intake in children and its consequences on blood pressure

“…2). Interestingly, the effect of this intervention on infant weight remained significant after supplementation ceased [19]. In contrast, full-term infants fed breast milk receive ∼ 1 mmol/kg per day of sodium, which is enough for an equilibrated growth [6].…”

“…The green histograms depict the course of sodium balance among preterm infants who received a sodium supplementation of 4-5 mmol/kg/day. Adapted with permission from[19] …”

Influence of NaCl Supplementation on Vasopressin Secretion and Water Excretion in Premature Infants

“…Accordingly, increasing the daily so dium intake to 3 mmol/kg reduces its inci dence from 30-40 to 10% percent [3] and increasing it to 3-5 mmol/kg practically elimi nates it [9][10][11]. Furthermore, Shaffer and Meade [12] have observed significantly lower plasma sodium concentrations in infants re ceiving sodium in a dose of 1 mmol/kg/day than in those on 3 mmol/kg/day over a period of 30 days, the pattern of sodium balance, however, remained similar.…”

Особливості Діагностики Та Лікування Гіпонатріємії В Дітей

“…Бла-годаря этому обеспечивается физиологическая ре-тенция солей и азотистых продуктов, необходимых для роста и развития. Из-за сниженной концентра-ционной способности для выведения осмотически активных метаболитов необходимо большее коли-чество воды, и значительные нагрузки жидкостью, получаемые ребенком в раннем возрасте с пищей, компенсируются экскрецией разведенной мочи (гипостенурия) [9].…”