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Increased bone mineral content of preterm infants fed with a nutrient enriched formula after discharge from hospital
N J Bishop1, F J King, A Lucas
1Department of Paediatrics, University of Cambridge.
Insights
Enhanced milk formula significantly improved bone mineralisation in preterm infants after hospital discharge. This nutritional support aids bone growth during critical development periods.
Area of Science:
- Neonatal Nutrition
- Pediatric Bone Health
- Mineral Metabolism
Background:
- Premature infants often experience persistent bone disease due to reduced bone mineralization.
- Nutritional support after hospital discharge is crucial for catch-up growth and development in preterm infants.
Purpose of the Study:
- To investigate if enhanced nutritional intake post-discharge improves bone mineralization in formula-fed preterm infants.
- To compare the effects of standard versus multinutrient-enriched milk on bone mineral content.
Main Methods:
- Randomized controlled trial involving 31 formula-fed preterm infants.
- Infants received either standard or enriched milk formula after discharge.
- Bone mineral content was measured before discharge and at 3 and 9 months corrected postnatal age.
Main Results:
- No initial difference in bone mineral content before discharge.
- Significantly higher bone mineral content in the enriched formula group at 3 months (83 vs 63 mg/cm) and 9 months (115 vs 95 mg/cm).
- Enriched formula group reached bone mineral content comparable to normal infants by 9 months, adjusted for body size.
Conclusions:
- Post-discharge use of a nutrient-enriched formula positively impacts bone growth and mineralization in preterm infants.
- Enhanced nutrition is effective in improving bone health during rapid skeletal development phases.
- The study supports the use of specialized formulas for optimizing bone outcomes in vulnerable preterm populations.
Abstract:
Bone disease with persistent reduced bone mineralisation is common in premature infants. To test the hypothesis that enhancement of nutritional intake after discharge from hospital improves bone mineralisation, 31 formula fed preterm infants were randomly assigned to receive standard or multinutrient enriched milk from the time of discharge. The calcium and phosphorus contents of the enriched milk were 70 and 35 mg/100 ml v 35 and 29 mg/100 ml for the standard formula. Bone mineral content was measured before discharge from hospital in 21 of the infants; there was no difference in the bone mineral content between the groups at that time (35 mg/cm for the two groups). There was a significant increase in bone mineral content for those infants receiving the enriched v standard formula at 3 and 9 months corrected postnatal age: at 3 months the bone mineral content was 83 v 63 mg/cm and at 9 months 115 v 95 mg/cm. The difference between the groups was thus maintained although not increased at a corrected age of 9 months, when the bone mineral content of infants fed the enriched but not the standard formula was no longer significantly different from that of normal infants after adjusting for body size. The difference was not explained by the larger body size in infants fed the enriched formula. The results suggest that the use of a special nutrient enriched postdischarge formula has a significant positive effect on bone growth and mineralisation during a period of rapid skeletal development.