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Enriched post-discharge formula versus term formula for bone strength in very low birth weight infants: a
Ita Litmanovitz1, Alon Eliakim, Shmuel Arnon
1Department of Neonatology, Meir Medical Center, Kfar Saba, Israel. litmani@clalit.org.il
Insights
Nutrient-enriched post-discharge formula (PDF) did not show short-term benefits for bone strength in very low birth weight (VLBW) infants compared to standard formula. Bone strength improved in both groups, but no significant differences were observed between them.
Area of Science:
- Neonatal nutrition
- Pediatric bone health
- Growth and development
Background:
- Very low birth weight (VLBW) infants face challenges in achieving optimal bone mineralization post-discharge.
- Nutrient-enriched post-discharge formula (PDF) is designed to support growth and bone development in these vulnerable infants.
- Understanding the impact of specialized formulas on bone health is crucial for improving long-term outcomes.
Purpose of the Study:
- To compare the effects of nutrient-enriched post-discharge formula (PDF) versus standard term formula (TF) on bone strength in VLBW infants.
- To assess bone speed of sound (SOS) and bone turnover markers in VLBW infants fed different formulas.
- To evaluate anthropometric growth in VLBW infants receiving PDF or TF.
Main Methods:
- A longitudinal pilot study involving two matched groups of VLBW infants (n=10 each).
- Random assignment to receive either enriched PDF or TF starting at 40 weeks corrected age.
- Measurements included anthropometrics, bone SOS, and bone turnover markers (bone-specific alkaline phosphatase, cross-linked carboxy terminal telopeptide of type I collagen) at term, 3, and 6 months corrected age.
Main Results:
- Both PDF and TF groups showed significant increases in bone SOS from term to six months corrected age.
- No statistically significant differences in anthropometric measurements or bone SOS were found between the PDF and TF groups.
- Bone turnover markers decreased significantly in both groups over the study period.
Conclusions:
- Nutrient-enriched post-discharge formula (PDF) did not demonstrate a short-term beneficial effect on bone strength or turnover in VLBW infants compared to standard term formula.
- Further research with larger sample sizes may be needed to elucidate potential long-term effects.
- Both formulas supported bone development, but PDF offered no immediate advantage in this pilot study.
Aim:
To initiate a longitudinal pilot study comparing the effect of nutrient-enriched post-discharge formula (PDF) with standard term formula (TF) on bone strength of very low birth weight (VLBW) infants in the first six months post-term.
Methods:
Two matched groups of VLBW infants were randomly assigned to enriched PDF (n=10) or TF (n=10) at corrected age of 40 weeks. Anthropometric measurements of growth and measurements of bone speed of sound (SOS) indicating bone strength and bone turnover markers (bone-specific alkaline phosphatase and cross-linked carboxy terminal telopeptide of type I collagen) were taken at term and at three and six months corrected age.
Results:
The anthropometric measurements of infants fed PDF and TF were comparable at three and six months corrected age. Bone SOS of the PDF group increased from 2760+/-113 m/s at term to 2877+/-90 m/s and 3032+/-60 m/s at three and six months corrected age, respectively (P<0.001). Likewise, bone SOS of the TF group increased from 2695+/-116 m/s at term to 2846+/-72 and 2978+/-83 m/s at three and six months, respectively (P<0.001). No statistically significant difference was found between the groups in terms of growth and bone SOS measurements. The levels of both bone turnover markers decreased significantly during the study period (P<0.001 for both groups).
Conclusion:
Feeding with PDF after term had no short-term beneficial effect on bone strength and bone turn-over of VLBW infants.
