The role of vitamin E in the nutrition of premature infants.

Vitamin E (alpha-tocopherol) has been credited with a variety of beneficial effects in the premature newborn infant. It has been thought that deficiency of vitamin E is at least partly responsible for the anemia which often occurs 4 to 6 wk after premature birth, and routine dietary supplementation with vitamin E is frequently recommended. However, critical analysis reveals that published controlled studies of vitamin E supplementation do not agree on the magnitude or even the existence of this protective effect against anemia. Analysis of commonly used feeding practices suggests that the dietary ratio of alpha-tocopherol to polyunsaturated fatty acids is generally sufficient to prevent manifestations of vitamin E deficiency without supplementation. Large parenteral doses of vitamin E have been purported to protect premature infants exposed to oxygen-enriched environments and mechanical ventilation from the complications of retrolental fibroplasia and bronchopulmonary dysplasia. Subsequent studies, however, have not yet substantiated encouraging early reports of these protective effects. At present, there seems to be no clearly established need for supplementing the premature infant's usual dietary intake of vitamin E.