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Calcium and phosphorus homeostasis in very-low-birth-weight infants appropriate for gestational age fed human milk

G Boehm1, B Kirchner

  • 1Department of Paediatrics, Karl Marx-University, Leipzig, GDR.

Biomedica Biochimica Acta
|January 1, 1988
PubMed

Insights

Very-low-birth-weight (VLBW) infants fed human milk may have latent phosphorus deficiency. Supplementing with sodium dihydrogen phosphate (NaH2PO4) improved phosphorus levels but intake may still be insufficient for optimal mineral metabolism.

Area of Science:

  • Neonatology
  • Pediatric Nutrition
  • Mineral Metabolism

Background:

  • Human milk is the primary nutrition source for many infants, but its mineral content may be insufficient for very-low-birth-weight (VLBW) infants.
  • VLBW infants have unique nutritional needs due to immature organ systems and rapid growth.
  • Assessing mineral balance, particularly calcium and phosphorus, is crucial for VLBW infant development.

Purpose of the Study:

  • To evaluate serum calcium, phosphorus, and alkaline phosphatase activity in VLBW and low-birth-weight (LBW) infants.
  • To assess the impact of human milk supplementation with sodium dihydrogen phosphate (NaH2PO4) on mineral excretion.
  • To determine if human milk alone supports adequate phosphorus levels in VLBW infants.

Main Methods:

  • Serum calcium, phosphorus, and alkaline phosphatase were measured on days 7, 21, and 42 in 42 VLBW and 83 LBW infants.
  • Renal excretion of calcium and phosphorus was measured in a subgroup of infants fed either human milk or human milk supplemented with NaH2PO4.
  • Infant groups were compared based on feeding type and birth weight.

Main Results:

  • Serum mineral parameters were within normal ranges for all infants.
  • VLBW infants showed a tendency towards conserving phosphorus and excreting more calcium compared to LBW infants.
  • NaH2PO4 supplementation increased urinary phosphorus excretion and decreased calcium excretion in VLBW infants, though values remained lower than in LBW infants.
  • Alkaline phosphatase activity was normal, suggesting no delayed bone mineralization.

Conclusions:

  • VLBW infants fed human milk may experience latent phosphorus deficiency, indicated by renal excretion patterns.
  • Human milk's phosphorus concentration may be too low and its calcium/phosphorus ratio too high for optimal VLBW infant mineral metabolism.
  • NaH2PO4 supplementation improves phosphorus status but optimal intake requires further investigation; urinary calcium/phosphorus ratio is a potential marker for latent phosphorus deficiency.

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