Postnatal attainment of intrauterine macromineral accretion rates in low birth weight infants fed fortified human milk.
OBJECTIVE
Provision of more bioavailable mineral sources as human milk supplements enables very low birth weight (VLBW) infants to meet the intrauterine accretion rate for calcium and phosphorus.


METHODS
Comparison of currently formulated human milk fortifier with previous formulation.


METHODS
Neonatal level II and III nurseries.


METHODS
Twenty-six healthy, VLBW infants, whose mothers chose to breast-feed.


METHODS
We tested the effects of two formulations designed for VLBW infants as human milk supplements and differing primarily in their quantity and source of Ca, P, and magnesium. The study interval began with a milk intake of 100 ml.kg-1.day-1 and ended when a body weight reached 2.0 kg.


METHODS
Net absorption and retention of Ca, P, and Mg during a nutritional balance study conducted once during the study interval, growth during the entire study interval, and bone mineral content of the radius were measured at the beginning and end of the study interval.


RESULTS
The newer Ca gluconate-glycerophosphate preparation (given to group CaGP) resulted in greater net absorption and retention of Ca and P (p < 0.01) than in infants given Ca phosphate (group CaTB). Mg retention was greater than (in group CaGP) or equivalent to (in group CaTB) the intrauterine accretion rate. Radius bone mineral content was significantly greater in group CaGP than in group CaTB (p < 0.001). Volumes of the fortified human milk preparation needed to meet the needs for gain in body weight were higher in group CaGP than in group CaTB (p < 0.001).


CONCLUSIONS
Intrauterine accretion rates for Ca and P can be achieved when VLBW infants are fed human milk supplemented with Ca gluconate-glycerophosphate. Supplementation of human milk with Mg may not be indicated. In this study, greater intakes of Ca and P, and not improvements in bioavailability, result in improved net retention and bone mineral content of VLBW infants.
Schanler
R J
RJ
U.S. Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas 77030.
Abrams
S A
SA
D000042:Absorption; D001682:Biological Availability; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000493:pharmacokinetics*; D005527:Food, Fortified; D006801:Humans; D007230:Infant, Low Birth Weight / Q000254:growth & development / Q000378:metabolism*; D007231:Infant, Newborn; D008274:Magnesium / Q000493:pharmacokinetics; D008895:Milk, Human / Q000378:metabolism*; D010758:Phosphorus / Q000493:pharmacokinetics*
D010758:Phosphorus; D008274:Magnesium; D002118:Calcium