Why should babies with diarrhea take zinc supplements?

1. Why do you need zinc supplement for diarrhea?

Zinc is an essential trace element for the human body. Zinc deficiency can lead to growth retardation, recurrent infections, hypogonadism or delayed sexual maturation, pica, diarrhea, and skin lesions of varying degrees. Diarrhea can lead to abnormally increased zinc excretion, and diarrheal disease can cause secondary zinc deficiency, which is mutually causal and aggravates zinc deficiency, forming a vicious cycle. Zinc supplementation can reduce the duration and severity of diarrhea, improve the clinical prognosis of children with acute and chronic diarrhea, and reduce the recurrence of diarrhea [1].

2. How to prevent zinc deficiency in babies

Zinc supplementation should be prioritized over daily dietary zinc supplementation. Normal breastfeeding is usually sufficient to correct zinc deficiency in premature infants. For infants and young children after 6 months of age, breastfeeding alone can no longer meet their nutritional needs for zinc. If the zinc content of complementary foods is low, the risk of zinc deficiency in infants and young children will increase, especially when children have diarrhea, which will aggravate zinc loss and make zinc deficiency more serious. Zinc in the human body is mainly obtained through diet, so adhere to a balanced diet. Fruits, vegetables, and root vegetables have low zinc content, so a diet based on plant foods is prone to zinc deficiency. It is necessary to reasonably combine animal and plant foods, avoid partial eating, and eat some red meat (beef, lean pork, liver, etc.), some seafood, fish, poultry, etc. that are rich in zinc [2].

3. Which drug is better for zinc supplementation? When zinc deficiency occurs, the first thing to do is to actively eliminate and correct the cause of zinc deficiency. If the mother's zinc reserves are over-depleted or zinc is deficient, breast milk may be zinc deficient. If breast milk secretion is low, the baby will need to supplement. In areas with high incidence of zinc deficiency and in malnourished children, zinc supplementation can shorten the duration of diarrhea in children aged 6 months to 5 years [3]. Zinc supplementation should be administered orally, and zinc supplements that are easily soluble in water, easy to absorb, have a good taste, and are low in cost should be selected. The WHO Guidelines for Acute Diarrhea recommend the selection of zinc salts with good water solubility, including zinc sulfate, zinc acetate, and zinc gluconate. Commonly used zinc supplements are shown in the table below [2].

Since zinc preparations are mildly irritating to the gastrointestinal tract, they are best taken after meals. Calcium and iron preparations can reduce zinc absorption rates by competitively inhibiting or interfering with multiple links in zinc absorption, so they should not be taken at the same time.

References

[1] Gastroenterology Group, Pediatrics Branch, Chinese Medical Association, Editorial Committee of Chinese Journal of Pediatrics. Clinical practice guidelines for acute infectious diarrhea in children in China[J]. Chinese Journal of Pediatrics, 2016, 54(7):483-488.

[2] Expert consensus writing group on clinical prevention and treatment of zinc deficiency in children, Pediatric Committee of Chinese Association of Research Hospitals. Expert consensus on clinical prevention and treatment of zinc deficiency in children[J]. Journal of Pediatric Pharmacy, 2020(3):46-50.

[3] Ni Xin, Wang Baoxi, Wang Quan, et al. Diagnosis and treatment guidelines for acute infectious diarrhea in children (2020 edition)[J]. Chinese Journal of Medical Science, 2020, 10(21): 249-256.