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Enteral Calcium or Phosphorus Supplementation in Preterm or Low Birth Weight Infants: a Systematic Review and

Mohan Kumar1, Ranadip Chowdhury1,2, Bireshwar Sinha1,2

  • 1Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.

Pediatrics
|August 3, 2022
PubMed

Insights

Enteral supplementation with calcium or phosphorus in human milk-fed preterm infants showed a reduction in osteopenia. However, evidence is insufficient to determine overall benefits or harms for these vulnerable infants.

Area of Science:

  • Neonatal Nutrition
  • Pediatric Gastroenterology
  • Clinical Nutrition

Background:

  • Preterm and low birth weight infants fed human milk are at risk for mineral deficiencies.
  • Osteopenia is a common complication in these infants, impacting bone health.
  • Supplementation with calcium and phosphorus is a common practice to address these deficiencies.

Purpose of the Study:

  • To assess the effects of calcium or phosphorus supplementation versus no supplementation in human milk-fed preterm or low birth weight infants.
  • To evaluate the impact of supplementation on osteopenia, growth parameters, and biochemical markers.
  • To synthesize evidence from available randomized and non-randomized controlled trials.

Main Methods:

  • Searched major databases (Cochrane, Medline, Embase) for relevant trials.
  • Included randomized controlled trials (RCTs) and quasi-randomized trials.
  • Analyzed data from three studies involving 162 infants.

Main Results:

  • A reduction in osteopenia was observed at 38 weeks (RR 0.68, 95% CI 0.46-0.99).
  • No significant effects were found on weight, length, or head circumference at 6 weeks.
  • No significant effects were noted on alkaline phosphatase, serum calcium, or serum phosphorus levels.
  • The certainty of evidence was rated as very low to low.

Conclusions:

  • Current evidence is insufficient to determine the benefits or harms of enteral calcium or phosphorus supplementation in human milk-fed preterm infants.
  • Further high-quality research is needed to establish optimal supplementation strategies.
  • The findings highlight the need for careful consideration of supplementation in this population.
Abstract

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