The dose of zinc as 1 mg/kg was chosen based on zinc dosing in neonates as in standard texts [1,2]. The 10 mg tablets were dissolved in expressed breastmilk made upto 10 mL, and 1mL/kg of this was dispensed to the participants of this trial. Though the safety of zinc supplementation in empty stomach has not been demonstrated earlier, we did not encounter any adverse reactions in any of the 614 neonates enrolled in the trial.

We agree to some of your points mentioning lacunae in our study and hope that future studies on this topic would incorporate these suggestions. Our findings are indeed contrary to the findings of the study by Bhatnagar, et al. [3] and as suggested, further studies are required to understand the exact role of zinc as an adjunct in the treatment of infants/neonates with sepsis.

1. Douma CE, Gardner JS. Common neonatal intensive care unit medication guidelines. In: Cloherty JP, Eichenwald EC, Hansen AR, Stark AR (eds). Manual of Neonatal Care, 7thEdn. Philadelphia: Lippincott Williams and Wilkins; 2012. p. 886-932.

2. Gal P, Reed MD. Medications. In: Behrman RE, Kliegman RM,Jenson HB (ed). Nelson Textbook of Pediatrics, 19ed. Philadelphia: WB Saunders; 2011. p. 2432-2501.