[Phosphate depletion syndrome in prematures fed human milk]

The reason for our present study on calcium and phosphorus intake of 7 prematures (birthweight 1150-1620 g; 29-34 GW; 1000 IU Vit. D per day) with pooled human milk and on their parameters of calcium, phosphorus- and bone metabolism were reports of rickets in prematures despite sufficient Vit. D substitution. The daily calcium- and phosphorus intake with pooled human milk was considerably lower than intrauterine calcium-and phosphorus accretion of fetuses of comparable gestational age. Biochemical parameters from serum and urine clearly indicated a phosphate deficiency syndrome. We found a significantly positive correlation between the activity of alkaline phosphatase in serum and postconceptional age. Although no subject showed clinical or radiological signs of rickets, in 6 of them the activity of alkaline phosphatase was clearly above normal in the 39th or 40th postconceptional week. We conclude that pooled human milk cannot supply prematures with sufficient amounts of calcium and phosphorus.