Trace Element Deficiency in Infants and Children — Clinical practice —

Trace element deficiencies commonly encountered in Japanese infants and children are discussed. Premature birth infants have a high likelihood of developing deficiency of trace elements such as iron, zinc, and selenium, during the period of rapid growth from 2 months to 6 months of age. Breast-fed infants, in particular, are prone to develop trace element deficiency, and alopecia and dermatitis attributable to zinc deficiency have been reported. Furthermore, “followup milk” formulas (milk-substitute nutritional supplement for infants) in Japan contain practically no zinc or copper. Dependence on follow-up milk formulas as the main source of nutrition is associated with a high risk of zinc and copper deficiency. In one study, 60% of short-statured children without any endocrine disease were found to have zinc deficiency, and zinc administration was associated with an increase of body height. About 20 to 30% of adolescent and young women exhibit iron and zinc deficiency due to dieting. Excessive iodine intake by mothers during pregnancy has been suggested to be the cause of hyper-TSH-emia detected during the mass screening of neonates. Many enteral formulas in Japan do not contain selenium and iodine, and long-term administration of such formulas has been reported to be associated with deficiency of these elements.