ALUMINUM LEVELS IN TERM AND PREMATURE-INFANTS ON ENTERAL NUTRITION

So far aluminum (Al) status of infants has been studied in sick subjects. We report plasma and urinary Al levels in healthy enterally fed newborns. Term and preterm (gestational age at birth 32.4 +/- 0.5 weeks, mean +/- SEM) were 33 +/- 3 and 33 +/- 4 days old, respectively when studied. Breast milk Al content range was (n = 10) 0.68-3.7-mu-mol/a. Premature (n = 3) and standard formulas (n = 8) concentrations ranges were 4.54-8.25 and 1.19-3.32-mu-mol/l respectively. Mean plasma levels where higher in preterm (0.54 +/- 0.06-mu-mol/l, n = 29) than in fullterm babies (0.2 +/- 0.04-mu-mol/l; n = 61) (p < 0.001). Absolute urine concentrations were lower in preterm (0.86 +/- 0.82) than in fullterm babies (1.2 +/-2.68) (p < 0.02). However, when expressed as a ratio to urinary creatinine the urinary Al excretion displayed no difference between the two groups (0.68 +/- 0.11 VS 0.77 +/- 0.21-mu-mol Al/mmol creatinine). There was no correlation between plasma and urine Al concentrations in either group. The immature renal function of the preterm infant seems to impair the clearance of Al supplied by usual enteral feeding. Therefore even heathly preterms are at risk of Al loading; caution should be paid to keep Al supply as low as possible.