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Changes in serum parathyroid hormone-related protein in breastfed preterm infants

Amir Ben Tov1, Dror Mandel, Yossef Weissman

  • 1Department of Neonatology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Israel.

Breastfeeding Medicine : the Official Journal of the Academy of Breastfeeding Medicine
|April 16, 2011
PubMed

Insights

Parathyroid hormone-related protein (PTHrP) in preterm human milk does not affect infant serum PTHrP levels or calcium homeostasis. Maternal serum PTHrP correlates with human milk PTHrP, but infant absorption remains unproven.

Area of Science:

  • Endocrinology
  • Neonatal Nutrition
  • Human Milk Composition

Background:

  • Parathyroid hormone-related protein (PTHrP) activates parathyroid hormone receptors, potentially causing hypercalcemia.
  • High PTHrP concentrations are found in term and preterm human milk (HM).
  • The intestinal absorption and calcium homeostasis effects of PTHrP in preterm infants are unknown.

Purpose of the Study:

  • To assess the correlation between PTHrP concentrations in preterm human milk and PTHrP levels in maternal and neonatal serum.
  • To investigate the impact of PTHrP in preterm human milk on infant calcium homeostasis.

Main Methods:

  • Collected expressed human milk from 16 mothers of preterm infants (25-34 weeks gestation).
  • Drew maternal and infant blood samples on postpartum days 2 and 10.
  • Measured PTHrP, calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP) concentrations using immunoradiometric assay and standard laboratory methods.

Main Results:

  • Maternal and neonatal serum PTHrP concentrations showed no significant change over 10 days of breastfeeding.
  • A correlation was found between maternal serum PTHrP and human milk PTHrP (R² = 0.24, p = 0.04).
  • No correlation was observed between human milk PTHrP and neonatal serum PTHrP, or between human milk PTHrP and neonatal serum Ca, P, or ALP concentrations.

Conclusions:

  • Despite high PTHrP in preterm human milk, infant serum PTHrP levels did not increase.
  • No correlation was found between human milk PTHrP and neonatal serum calcium levels.
  • The intestinal absorption and calcium regulatory role of PTHrP from human milk in preterm infants require further investigation.
Abstract

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