Neonatal hypercalcemia in preterm infants fed with human milk

Area of Science:

• Neonatology
• Pediatric Endocrinology
• Nutritional Science

Background:

• Hypercalcemia, defined as serum calcium (Ca) ≥ 2.83 mmol/l, is a concern in premature infants.
• Human breast milk is the primary nutrition source for many premature infants.
• Understanding metabolic disturbances in this population is crucial for optimal care.

Purpose of the Study:

• To investigate the potential link between human breast milk feeding and hypercalcemia in premature infants.
• To identify metabolic factors associated with neonatal hypercalcemia.
• To determine effective interventions for correcting hypercalcemia in this cohort.

Main Methods:

• Observational study of 10 premature infants with hypercalcemia (gestational age 31-37 weeks, birthweight 1100-1950 g).
• Analysis of serum calcium, phosphorus, parathyroid hormone, and 25-hydroxyvitamin-D levels.
• Measurement of urinary calcium and phosphorus excretion.
• Correlation analysis between serum calcium and excretion parameters.

Main Results:

• All infants were fed pooled human breast milk.
• High urinary calcium excretion and low serum/urinary phosphorus were observed.
• Serum parathyroid hormone and vitamin D levels were normal.
• Positive correlation between serum calcium and urinary calcium excretion; negative correlation with serum phosphorus and urinary phosphorus excretion.

Conclusions:

• Neonatal hypercalcemia in premature infants appears related to phosphorus depletion.
• Human breast milk may contribute to this phosphorus depletion.
• Phosphorus supplementation or modified milk feeding effectively corrected hypercalcemia.