Zinc in neonatal health: a mini-review

Abstract

Zinc is an essential trace element with catalytic, structural, and regulatory functions relevant to neonatal growth, immune competence, epithelial integrity, neurodevelopment, and metabolic programming. Neonates at greatest risk of zinc deficiency include preterm and very-low-birth-weight infants, growth-restricted newborns, exclusively breastfed infants and infants with prolonged parenteral nutrition, high gastrointestinal losses, or severe systemic disease. This mini-review summarizes current evidence on zinc in neonatal health, with emphasis on biological plausibility, clinical manifestations of deficiency, and the potential benefits and limits of supplementation. Zinc supplementation may improve short-term growth in selected preterm or low-birth-weight infants, while effects on bronchopulmonary dysplasia, long-term neurodevelopment, and other prematurity-related outcomes remain uncertain. Zinc has also been evaluated as an adjunct to phototherapy for neonatal hyperbilirubinemia and as an adjunct to antibiotics in young-infant sepsis, but heterogeneity in populations, dosing, timing, and outcomes precludes routine use. Associations between zinc status and autism spectrum disorder or later cardiometabolic outcomes remain biologically plausible but not clinically proven. Overall, zinc supplementation in neonates should be targeted to documented or strongly suspected deficiency and high-risk clinical contexts, with monitoring for efficacy, safety, and interactions with other trace elements.