title: Impact of Early Sodium Supplementation on Hyponatremia and Growth in Premature Infants: A Randomized Controlled Trial.
abstract: BACKGROUND
  We tested the hypothesis that sodium supplementation in early preterm infants prevents late-onset hyponatremia and improves growth without increasing common morbidities during birth hospitalization.
  
  
  METHODS
  This was a randomized, masked controlled trial of 4 mEq/kg/d of sodium (intervention) versus sterile water (placebo) from days-of-life 7 to 35 in infants born at <32 weeks corrected gestational age. The primary outcome was weight gain in the first 6 weeks of life. Secondary outcomes included weekly serum sodium concentrations, growth in body length and head circumference, and complications of prematurity during birth hospitalization.
  
  
  RESULTS
  Fifty-three infants with an average corrected gestational age of 28.5 ± 2.4 weeks were randomized. Infants receiving the intervention had fewer (P = .012) reports of serum sodium concentrations <135 mmol/L and greater velocity of weight gain during the study period, mean (SD) 26.9 (3.1) vs 22.9 (4.7) g/kg/day, P = .012. At 6 weeks of age, infants <28 weeks' gestation who received sodium supplementation had greater percentage weight change from birth, mean (SD) 193% (22%) vs 173% (10%), P = .041, and maintained fetal reference birth percentile for body weight more often (P = .002) compared with infants receiving placebo. Growth in length and head circumference was not significantly different between study arms. No increase in common prematurity-related morbidities was detected in infants who received supplemental sodium chloride.
  
  
  CONCLUSIONS
  Sodium supplementation of enteral feedings in very premature infants averts hyponatremia and enhances weight gain.
authors.affiliation: University of Cincinnati Medical Center, Cincinnati, Ohio barbara.isemann@uchealth.com.
authors.forename: Barbara
authors.initials: B
authors.lastname: Isemann
authors.affiliation: University of Cincinnati Medical Center, Cincinnati, Ohio.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Mueller
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Vivek
authors.initials: V
authors.lastname: Narendran
authors.affiliation: Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors.forename: Henry
authors.initials: H
authors.lastname: Akinbi
mesh_terms: D019587:Dietary Supplements; D004750:Enteral Nutrition; D005260:Female; D005865:Gestational Age; D006801:Humans; D007010:Hyponatremia / Q000517:prevention & control*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D008297:Male; D012982:Sodium, Dietary / Q000008:administration & dosage* / Q000097:blood; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
chemical_list: D012982:Sodium, Dietary
keywords: anthropometrics; neonates; nutrition