Zinc deficiency in an exclusively breast-fed preterm infant

Eur J Pediatr. 1995 Jan;154(1):71-5. doi: 10.1007/BF01972977.


A formerly premature, exclusively breast-fed infant with severe zinc deficiency syndrome is presented. He showed the characteristic erosive skin changes, including alopecia, as seen in acrodermatitis enteropathica. In addition, he manifested a failure to thrive and irritability. The diagnosis was confirmed by reduced serum levels of zinc (2.3 mumol/l) and alkaline phosphatase (45 U/l). We consider the reduced zinc supply in the breast milk (5.7 mumol/l) as the most likely cause of the disease. Therapy consisted of oral zinc supplements (50 mumol/kg/day) for a period of 30 weeks. Symptoms and laboratory values normalized completely and did not recur on a normal diet.

Conclusion: A diet of breast milk can, in rare circumstances, cause insufficient zinc intake resulting in severe zinc deficiency syndrome with characteristic dermatological features. Therapy consists of temporary oral zinc supplementation at a daily dose of 50 mumol/kg.

Publication types

  • Case Reports

MeSH terms

  • Alkaline Phosphatase / blood
  • Breast Feeding*
  • Failure to Thrive / blood
  • Failure to Thrive / etiology
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin G / blood
  • Infant, Newborn
  • Infant, Premature
  • Male
  • Skin Diseases / blood
  • Skin Diseases / etiology*
  • Skin Diseases / therapy
  • Zinc / blood
  • Zinc / deficiency*
  • Zinc / therapeutic use


  • Immunoglobulin A
  • Immunoglobulin G
  • Alkaline Phosphatase
  • Zinc