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Serum phosphorus levels in premature infants receiving a donor human milk derived fortifier

Katherine E Chetta1, Amy B Hair2, Keli M Hawthorne3

  • 1USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Section of Neonatology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA. kewiley@bcm.edu.

Nutrients
|April 28, 2015
PubMed

Insights

Premature infants receiving human milk fortified with donor human milk-derived fortifier (HMDF) may experience mild, temporary high serum phosphorus levels. This risk decreases with infant age and is not linked to birth weight or gender.

Area of Science:

  • Neonatal Nutrition
  • Pediatric Endocrinology
  • Human Milk Fortification

Background:

  • Anecdotal reports suggest elevated serum phosphorus (P) in premature infants fed donor human milk-derived fortifier (HMDF).
  • Prospective studies investigating serum P levels in this specific population are lacking.

Purpose of the Study:

  • To prospectively evaluate serum phosphorus levels in extremely premature infants fed an exclusive human milk-based diet with HMDF.
  • To identify factors associated with serum P elevations in this cohort.

Main Methods:

  • A single-center prospective observational cohort study.
  • Included 93 extremely premature infants (≤ 1250g birth weight).
  • Monitored serum P levels and analyzed correlations with infant characteristics and HMDF energy density.

Main Results:

  • 18.3% of infants had at least one high serum P level (mean 9.2 ± 1.1 mg/dL) around 19 days of life.
  • Highest serum P was inversely correlated with infant age (p < 0.001) and positively correlated with HMDF energy density (p = 0.035).
  • Serum P showed no significant relationship with gender, birth weight, gestational age, or time to full feeds.

Conclusions:

  • Hyperphosphatemia incidence in premature infants receiving HMDF was mild and transient.
  • Risk of elevated serum P decreased with infant age.
  • Serum P levels were not significantly related to infant demographics or feeding milestones.

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