Purpose: This review aims to provide an overview of the factors and clinical outcomes associated with selenium deficiency and the guidelines on the optimal selenium supplementation in infants.
Current concept: Selenium is a cofactor required to mainta...
Purpose: This review aims to provide an overview of the factors and clinical outcomes associated with selenium deficiency and the guidelines on the optimal selenium supplementation in infants.
Current concept: Selenium is a cofactor required to maintain the activity of glutathione peroxidase and is an essential trace element in the human body. Selenium is involved in many stages of oxidative injury within the human body. In severe cases, selenium deficiency may lead to cardiomyopathy. Particularly in infants, the risk factors for selenium deficiency are preterm birth and long-term parenteral nutrition. Several studies have been conducted on the relationship between selenium deficiency and bronchopulmonary dysplasia, retinopathy of prematurity, and sepsis, all of which are common diseases in preterm infants. In the past, 2-3 mcg/kg/day of intravenous selenium supplementation was recommended in preterm infants with selenium deficiency. However, recent studies have suggested that only 2-3 mcg/kg/day can prevent further decreases of selenium level in the blood of preterm infants, and that higher supplementation of 1.5-4.5 mcg/kg/day or 7 mcg/kg/day is necessary to reach the level of healthy infants at term. The recommended dose of selenium through enteral nutrition for preterm infants is 1.3-4.5 mcg/kg/day or 5-10 mcg/kg/day, depending on the guideline.
Conclusion: Adequate selenium administration is required for adequate nutritional support in infants to prevent selenium deficiency, and more studies should be conducted to establish dosing guidelines considering risk factors in preterm infants.