Do healthy premature infants fed breast milk need vitamin E supplementation: alpha- and gamma-tocopherol levels in blood components and buccal mucosal cells.

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 alpha-tocopherol level (below 500 microg/dL) accompanied by a low tocopherol to lipid ratio or increased hydrogen peroxide hemolysis of erythrocytes. In the present study, we determined alpha- and gamma-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. Alpha- and gamma-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.