Transient neonatal zinc deficiency in exclusively breastfed preterm infants

We describe seven cases of transient neonatal zinc deficiency (TNZD), with the clinical and demographic features summarised in Table 1 and clinical images in Figures 1 and 2. The early dermal features included scrotal oedema, a ‘dribble rash’, and alopecia. All infants demonstrated marked irritability, which resolved rapidly when zinc supplementation was instituted. Infants were treated with various oral liquid zinc preparations, 1–6 mg elemental zinc/kg/day. Treatment duration in our cohort varied markedly, ranging from 2 weeks to 14 months. Our infants are now 15–50 months post‐natal age and all thriving without physical or neurocognitive impairment; however, infant 7 was lost to medical follow‐up shortly after diagnosis. Half of the mothers had excessive milk supply, discarding up to 1.8 l (i.e. 75%) of expressed breast milk per day throughout lactation to the time of diagnosis. While the zinc content in the milk was in the low normal range, 60–75% of the zinc excreted in the breast milk per 24 h was discarded.No Full Tex