Calcium and phosphorus homeostasis in very-low-birth-weight infants appropriate for gestational age fed human milk. 1988

G Boehm, and B Kirchner
Department of Paediatrics, Karl Marx-University, Leipzig, GDR.

The concentrations of calcium and phosphorus and the activity of alkaline phosphatase in serum were evaluated in 42 very-low-birth-weight (VLBW) and 83 low-birth-weight (LBW) infants on the 7th, 21st, and 42nd day of life. 9 VLBW and 16 LBW infants were randomized for measurement of the renal excretion of calcium and phosphorus on the 3rd, 5th, 7th, 21st, and 42nd day of life during human milk feeding and 14 VLBW-infants fed human milk supplemented with 1 mmol NaH2PO4 per 100 ml. All serum parameters were found to be normal. Supplementation of human milk with NaH2PO4 leads to a tendency of higher concentrations of phosphorus than found in VLBW-infants exclusively fed with native human milk, but all differences between the two groups were not significant. VLBW-infants appeared more than LBW-infants to be conserving phosphorus and wasting calcium during human milk feeding. Supplementation of human milk with NaH2PO4 results in higher phosphorus lower calcium excretion in urine of VLBW-infants, but they do not reach the values of LBW-infants. Because the activity of alkaline phosphatase was not different between the feeding groups and in all cases within the normal range a delayed bone mineralisation cannot be assumed in the infants studied. Thus, the phosphorus deficiency which is shown by the renal excretion of calcium and phosphorus in the VLBW-infants can be considered to be latent. In the light of our data the concentration of phosphorus in human milk seems to be too low and the calcium/phosphorus ratio too high for the optimal mineral metabolism in VLBW-infants. The supplementation used improves the situation, but the phosphorus intake seems still too low. Further investigations are needed to detect the optimal phosphorus intake for these infants. The calcium/phosphorus ratio in the urine is a good marker to estimate a latent phosphorus deficiency in VLBW-infants.

UI MeSH Term Description Entries
D007230 Infant, Low Birth Weight An infant having a birth weight of 2500 gm. (5.5 lb.) or less but INFANT, VERY LOW BIRTH WEIGHT is available for infants having a birth weight of 1500 grams (3.3 lb.) or less. Low Birth Weight,Low-Birth-Weight Infant,Birth Weight, Low,Birth Weights, Low,Infant, Low-Birth-Weight,Infants, Low-Birth-Weight,Low Birth Weight Infant,Low Birth Weights,Low-Birth-Weight Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008297 Male Males
D008895 Milk, Human Milk that is produced by HUMAN MAMMARY GLANDS. Breast Milk,Human Milk,Milk, Breast
D010758 Phosphorus A non-metal element that has the atomic symbol P, atomic number 15, and atomic weight 31. It is an essential element that takes part in a broad variety of biochemical reactions. Black Phosphorus,Phosphorus-31,Red Phosphorus,White Phosphorus,Yellow Phosphorus,Phosphorus 31,Phosphorus, Black,Phosphorus, Red,Phosphorus, White,Phosphorus, Yellow
D002118 Calcium A basic element found in nearly all tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. Coagulation Factor IV,Factor IV,Blood Coagulation Factor IV,Calcium-40,Calcium 40,Factor IV, Coagulation
D005260 Female Females
D006706 Homeostasis The processes whereby the internal environment of an organism tends to remain balanced and stable. Autoregulation
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000469 Alkaline Phosphatase An enzyme that catalyzes the conversion of an orthophosphoric monoester and water to an alcohol and orthophosphate. EC 3.1.3.1.

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