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Bone mineralization in former very low birth weight infants fed either human milk or commercial formula
S A Abrams1, R J Schanler, C Garza
1Children's Nutrition Research Center, Houston, TX 77030.
Insights
Exclusive human milk feeding after hospital discharge may pose mineral deficiency risks for very low birth weight infants. Formula-fed infants showed better bone mineral status and phosphorus levels.
Area of Science:
- Neonatal Nutrition
- Pediatric Bone Health
- Mineral Metabolism
Background:
- Very low birth weight (VLBW) infants require careful nutritional management post-discharge.
- Human milk is often recommended, but its mineral content may vary.
- Assessing bone mineral status in VLBW infants is crucial for long-term health.
Purpose of the Study:
- To evaluate the bone mineral status of VLBW infants fed either commercial formula or unfortified human milk after hospital discharge.
- To compare bone mineral content, biochemical markers, and growth between feeding groups.
- To identify potential risks associated with posthospitalization feeding strategies.
Main Methods:
- Longitudinal study evaluating VLBW infants post-discharge.
- Measurements included anthropometrics, bone mineral content (BMC), bone width, serum calcium, phosphorus, albumin, and alkaline phosphatase.
- Infants were divided into human milk (HM) and commercial formula (CM) groups.
Main Results:
- At 16 and 25 postnatal weeks, group HM showed significantly lower BMC, BMC/bone width ratio, and serum phosphorus compared to group CM.
- Group HM also exhibited higher alkaline phosphatase activity, indicating potential bone mineralization issues.
- Growth parameters were comparable between the two feeding groups.
Conclusions:
- Exclusive human milk feeding in VLBW infants post-discharge may be associated with suboptimal bone mineral status and phosphorus levels.
- Commercial formula feeding appeared to support better bone mineral accrual in this cohort.
- VLBW infants exclusively fed human milk may be at risk for mineral deficiencies, warranting further investigation and potential fortification strategies.
Abstract:
The bone mineral status of former very low birth weight infants previously fed fortified human milk was evaluated during the posthospitalization period. Anthropometric measurements, bone mineral content, bone width, serum calcium, phosphorus, and albumin concentrations, and alkaline phosphatase activity were evaluated at 10, 16, and 25 postnatal weeks. Infants were fed either commercial formula or unfortified human milk after their hospital discharge. At 16 and 25 weeks postnatally, human milk-fed infants (group HM) had lower bone mineral content (P less than 0.01), bone mineral content/bone width ratio (p less than 0.01), serum phosphorus concentration (p less than 0.03), and higher alkaline phosphatase activity (p less than 0.01) than commercial formula-fed infants (group CM). Growth was similar in both groups. Bone mineral content was correlated positively to serum phosphorus (r = 0.52, p less than 0.05) and inversely to alkaline phosphatase activity (r = -0.63, p less than 0.01) at 25 weeks postnatally. The use of serum biochemical markers, however, could account for only 44% of the variability in bone mineral content. The exclusive feeding of human milk to very low birth weight infants after hospital discharge may place them at risk for mineral deficiencies.