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.
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- Bishop N. Bone disease in preterm infants. Arch Dis Child. 1989 Oct;64(10 Spec No):1403–1409. doi: 10.1136/adc.64.10_spec_no.1403. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bonjour J. P., Theintz G., Buchs B., Slosman D., Rizzoli R. Critical years and stages of puberty for spinal and femoral bone mass accumulation during adolescence. J Clin Endocrinol Metab. 1991 Sep;73(3):555–563. doi: 10.1210/jcem-73-3-555. [DOI] [PubMed] [Google Scholar]
- Chan G. M., Hess M., Hollis J., Book L. S. Bone mineral status in childhood accidental fractures. Am J Dis Child. 1984 Jun;138(6):569–570. doi: 10.1001/archpedi.1984.02140440053013. [DOI] [PubMed] [Google Scholar]
- Chan G. M., Mileur L. J. Posthospitalization growth and bone mineral status of normal preterm infants. Feeding with mother's milk or standard formula. Am J Dis Child. 1985 Sep;139(9):896–898. doi: 10.1001/archpedi.1985.02140110050027. [DOI] [PubMed] [Google Scholar]
- Chan G. M., Mileur L., Hansen J. W. Effects of increased calcium and phosphorous formulas and human milk on bone mineralization in preterm infants. J Pediatr Gastroenterol Nutr. 1986 May-Jun;5(3):444–449. doi: 10.1097/00005176-198605000-00019. [DOI] [PubMed] [Google Scholar]
- Congdon P. J., Horsman A., Ryan S. W., Truscott J. G., Durward H. Spontaneous resolution of bone mineral depletion in preterm infants. Arch Dis Child. 1990 Oct;65(10 Spec No):1038–1042. doi: 10.1136/adc.65.10_spec_no.1038. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cooper P. A., Rothberg A. D., Davies V. A., Argent A. C. Comparative growth and biochemical response of very low birthweight infants fed own mother's milk, a premature infant formula, or one of two standard formulas. J Pediatr Gastroenterol Nutr. 1985 Oct;4(5):786–794. doi: 10.1097/00005176-198510000-00018. [DOI] [PubMed] [Google Scholar]
- Dahlenburg S. L., Bishop N. J., Lucas A. Are preterm infants at risk for subsequent fractures? Arch Dis Child. 1989 Oct;64(10 Spec No):1384–1385. doi: 10.1136/adc.64.10_spec_no.1384. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gilsanz V., Roe T. F., Mora S., Costin G., Goodman W. G. Changes in vertebral bone density in black girls and white girls during childhood and puberty. N Engl J Med. 1991 Dec 5;325(23):1597–1600. doi: 10.1056/NEJM199112053252302. [DOI] [PubMed] [Google Scholar]
- Glastre C., Braillon P., David L., Cochat P., Meunier P. J., Delmas P. D. Measurement of bone mineral content of the lumbar spine by dual energy x-ray absorptiometry in normal children: correlations with growth parameters. J Clin Endocrinol Metab. 1990 May;70(5):1330–1333. doi: 10.1210/jcem-70-5-1330. [DOI] [PubMed] [Google Scholar]
- Greer F. R., McCormick A. Bone growth with low bone mineral content in very low birth weight premature infants. Pediatr Res. 1986 Oct;20(10):925–928. doi: 10.1203/00006450-198610000-00003. [DOI] [PubMed] [Google Scholar]
- Helin I., Landin L. A., Nilsson B. E. Bone mineral content in preterm infants at age 4 to 16. Acta Paediatr Scand. 1985 Mar;74(2):264–267. doi: 10.1111/j.1651-2227.1985.tb10962.x. [DOI] [PubMed] [Google Scholar]
- James J. R., Congdon P. J., Truscott J., Horsman A., Arthur R. Osteopenia of prematurity. Arch Dis Child. 1986 Sep;61(9):871–876. doi: 10.1136/adc.61.9.871. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Koo W. W., Gupta J. M., Nayanar V. V., Wilkinson M., Posen S. Skeletal changes in preterm infants. Arch Dis Child. 1982 Jun;57(6):447–452. doi: 10.1136/adc.57.6.447. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Landin L., Nilsson B. E. Bone mineral content in children with fractures. Clin Orthop Relat Res. 1983 Sep;(178):292–296. [PubMed] [Google Scholar]
- Larcos G., Wahner H. W. An evaluation of forearm bone mineral measurement with dual-energy X-ray absorptiometry. J Nucl Med. 1991 Nov;32(11):2101–2106. [PubMed] [Google Scholar]
- Lucas A., Bishop N. J., King F. J., Cole T. J. Randomised trial of nutrition for preterm infants after discharge. Arch Dis Child. 1992 Mar;67(3):324–327. doi: 10.1136/adc.67.3.324. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lucas A., Brooke O. G., Baker B. A., Bishop N., Morley R. High alkaline phosphatase activity and growth in preterm neonates. Arch Dis Child. 1989 Jul;64(7 Spec No):902–909. doi: 10.1136/adc.64.7_spec_no.902. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lyon A. J., McIntosh N., Wheeler K., Brooke O. G. Hypercalcaemia in extremely low birthweight infants. Arch Dis Child. 1984 Dec;59(12):1141–1144. doi: 10.1136/adc.59.12.1141. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Modanlou H. D., Lim M. O., Hansen J. W., Sickles V. Growth, biochemical status, and mineral metabolism in very-low-birth-weight infants receiving fortified preterm human milk. J Pediatr Gastroenterol Nutr. 1986 Sep-Oct;5(5):762–767. doi: 10.1097/00005176-198609000-00017. [DOI] [PubMed] [Google Scholar]
- Prentice A., Laskey M. A., Shaw J., Cole T. J., Fraser D. R. Bone mineral content of Gambian and British children aged 0-36 months. Bone Miner. 1990 Sep;10(3):211–224. doi: 10.1016/0169-6009(90)90263-f. [DOI] [PubMed] [Google Scholar]
- Rowe J., Rowe D., Horak E., Spackman T., Saltzman R., Robinson S., Philipps A., Raye J. Hypophosphatemia and hypercalciuria in small premature infants fed human milk: evidence for inadequate dietary phosphorus. J Pediatr. 1984 Jan;104(1):112–117. doi: 10.1016/s0022-3476(84)80606-x. [DOI] [PubMed] [Google Scholar]
- Sagy M., Birenbaum E., Balin A., Orda S., Barzilay Z., Brish M. Phosphate-depletion syndrome in a premature infant fed human milk. J Pediatr. 1980 Apr;96(4):683–685. doi: 10.1016/s0022-3476(80)80740-2. [DOI] [PubMed] [Google Scholar]
- Schanler R. J., Burns P. A., Abrams S. A., Garza C. Bone mineralization outcomes in human milk-fed preterm infants. Pediatr Res. 1992 Jun;31(6):583–586. doi: 10.1203/00006450-199206000-00009. [DOI] [PubMed] [Google Scholar]
- Steichen J. J., Gratton T. L., Tsang R. C. Osteopenia of prematurity: the cause and possible treatment. J Pediatr. 1980 Mar;96(3 Pt 2):528–534. doi: 10.1016/s0022-3476(80)80861-4. [DOI] [PubMed] [Google Scholar]
- Steichen J. J., Keriakes J. G., Tsang R. C. Radiation dose to small infants from single-photon absorptiometry. Radiology. 1988 Jul;168(1):169–170. doi: 10.1148/radiology.168.1.3380954. [DOI] [PubMed] [Google Scholar]
- Wahner H. W., Dunn W. L., Riggs B. L. Assessment of bone mineral. Part 2. J Nucl Med. 1984 Nov;25(11):1241–1253. [PubMed] [Google Scholar]