Related Experiment Videos
Bone mineralization outcomes in human milk-fed preterm infants
R J Schanler1, P A Burns, S A Abrams
1United States Department of Agriculture/Agricultural Research Service, Children's Nutrition Research Center, Houston, Texas 77030.
Insights
Preterm infants fed fortified human milk in the hospital showed similar bone mineral content at 2 years, regardless of continued human milk or formula feeding after discharge.
Area of Science:
- Pediatrics
- Neonatology
- Nutritional Science
Background:
- Preterm infants often experience impaired bone mineralization.
- Optimizing nutrition, including calcium and phosphorus, is crucial for bone health in preterm infants.
- Human milk fortification is a strategy to meet nutrient needs.
Purpose of the Study:
- To evaluate bone mineralization in preterm infants at 2 years of age.
- To compare bone mineral content (BMC) between infants fed human milk (HM) and cow milk-based formula (F) after hospital discharge.
- To assess the long-term impact of post-hospitalization feeding on bone development.
Main Methods:
- A cohort of preterm infants was studied from birth.
- Infants received fortified human milk (Ca, P) in the hospital.
- Post-discharge feeding groups: HM (human milk ≥2 months) and F (formula introduction).
- Mid-radius bone mineral content (BMC) was measured using single photon absorptiometry at 2 years.
- Anthropometric measurements (weight, length, bone width) were recorded.
Main Results:
- At 2 years, no significant difference in mid-radius BMC was found between the HM and F groups (180 ± 30 mg/cm).
- Previously observed differences in BMC at earlier time points (16, 25, 52 weeks) favoring the formula group diminished by 2 years.
- The 2-year cohort included healthy infants with similar birth characteristics and anthropometric measures.
Conclusions:
- Preterm infants fed fortified human milk in the hospital demonstrate catch-up bone mineralization by 2 years of age.
- Continued human milk feeding after hospital discharge supports bone development comparable to formula feeding.
- Adequate calcium and phosphorus fortification of human milk is essential for achieving optimal bone mineralization in preterm infants.
Abstract:
We evaluated bone mineralization by single photon absorptiometry at 2 y in a cohort of preterm infants studied since birth. Infants were fed human milk fortified with Ca [to achieve 80 mg/dL (19.96 mmol/L)] and P [40 mg/dL (12.91 mmol/L)] from wk 2 through 8 after birth. After hospital discharge, infants were divided into two groups (HM and F) determined by the timing of the introduction of cow milk-based formula. Mid-radius bone mineral content (BMC) was assessed in 10 infants who were breast-fed (HM) for a minimum of 2 mo after hospital discharge and 11 who were bottle-fed (F). The mean duration of human milk-feeding differed by design between HM and F groups (31 +/- 15 versus 11 +/- 3 wk, respectively). Although we had observed previously that group F had significantly greater BMC values at 16, 25, and 52 wk compared with values in group HM, we found similarities in BMC values (180 +/- 30 mg/cm) between groups at 2 y. The 2-y cohort comprised healthy infants and the groups had similar birth weights, lengths of gestation, and values for weight (10.8 +/- 1.1 kg), length (82 +/- 2 cm), and bone width (7.8 +/- 1.1 mm). Follow-up outcomes at 2 y in preterm infants fed fortified human milk in hospital suggest that if they continue to receive human milk after hospital discharge, radius BMC will "catch-up" to that of similar infants given formula in the posthospitalization period.