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Hypercalcaemia in extremely low birthweight infants.

A J Lyon, N McIntosh, K Wheeler

    Archives of Disease in Childhood
    |December 1, 1984
    PubMed
    Summary
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    Extremely low birthweight infants fed expressed breast milk and IV nutrition developed hypercalcemia and hypophosphatemia. Phosphate supplementation normalized calcium levels, but rickets of prematurity remained a concern.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Endocrinology
    • Nutritional Science

    Background:

    • Extremely low birthweight infants (<1000 g) are vulnerable to metabolic disturbances.
    • Hypercalcemia with hypophosphatemia can occur in neonates, particularly those receiving intravenous nutrition.
    • Rickets of prematurity is a common complication in preterm infants.

    Purpose of the Study:

    • To describe cases of hypercalcemia and hypophosphatemia in extremely low birthweight infants.
    • To investigate the association between feeding practices and these metabolic derangements.
    • To evaluate the efficacy of phosphate supplementation in treating these conditions.

    Main Methods:

    • Retrospective case series of 10 extremely low birthweight infants.
    • Analysis of feeding regimens (expressed breast milk and intravenous nutrition).

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  • Monitoring of plasma calcium and phosphate levels before and after phosphate supplementation.

    • Main Results:

    • All 10 infants presented with hypercalcemia and hypophosphatemia within the first two weeks of life.
    • Infants were primarily fed expressed breast milk with concurrent intravenous nutrition.
    • Phosphate supplementation successfully normalized plasma calcium concentrations.
    • A high incidence of rickets of prematurity was observed in this cohort.

    Conclusions:

    • Hypercalcemia with hypophosphatemia is a significant risk in extremely low birthweight infants on expressed breast milk and IV nutrition.
    • Phosphate supplementation is an effective treatment for this specific electrolyte imbalance.
    • Rickets of prematurity remains a prevalent issue despite correction of acute metabolic disturbances.