Calcium and phosphorus supplementation of human milk for preterm infants

Harding, Jane E; Wilson, Jessica; Brown, Julie

doi:10.1002/14651858.cd003310.pub2

Cited by 17 publications

(27 citation statements)

References 25 publications

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“…In addition, adequate early intake of protein and energy in the first week of life of VLBW infants improves the homeostasis of the electrolytes in question [52]. Preterm infants require high amounts of Ca and P elements and, due to low skeletal storages, are at increased risk of nutritional disorders such as growth and developmental deficits, hypophosphatemia, osteopenia in prematurity, and metabolic bone disease [53–54].…”

Section: Discussionmentioning

confidence: 99%

Development of a human milk concentrate with human milk lyophilizate for feeding very low birth weight preterm infants: A preclinical experimental study

et al. 2019

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Breast milk is considered the gold standard nutritional resource for very low birth weight (VLBW) infants in terms of nutrients and protective factors. If mother's milk is not available, the second choice is donated and fortified human milk (HM) from the Human Milk Bank (HMB). This study hypothesized that HM could be lyophilized and used as an additive to increase the levels of macronutrients and micronutrients available to VLBW infants. This study aimed to constitute a lyophilized HM concentrate and determine the osmolality and the concentration of macronutrients and micronutrients in HM samples at “baseline” and in “HM concentrates”, analyzed immediately (HMCI), and after 3 (HMC3m) and 6 (HMC6m) months of freezing. Osmolality was verified using the freezing point osmometric method. Macronutrient quantification was performed using the MIRIS Human Milk Analyzer. Micronutrients were determined by Flame Atomic Absorption Spectrophotometry and by the automated colorimetric method. Bayesian linear mixed effect models were adjusted using OpenBUGS to estimate mean differences and 95% credibility intervals (CrI) of osmolality and of macro- and micronutrients between the types of HM samples. A comparison of dosage values showed a significant increase between HM baseline and HMCI, HMC3m, and HMC6m. Comparing HM baseline and HMCI highlighted the increase in energy content and the concentration of carbohydrates and total lipids. The Ca and P contents increased and the levels of energy, total lipids, and Cu were reduced in HMC3m compared to HMCI. Ca, Mg, K, Zn, and P increased and the levels of energy, total lipids, and Cu were reduced in HMC6m, compared to HMCI. The present study confirms the possibility of formulation and utilization of the immediate concentrate. Partial stability of HM concentrates generated from freeze-drying of donated milk do not recommend storage.

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Section: Discussionmentioning

confidence: 99%

Development of a human milk concentrate with human milk lyophilizate for feeding very low birth weight preterm infants: A preclinical experimental study

et al. 2019

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“…Despite lack of evidence from randomised controlled trials [25, 26], supplementing human milk with calcium and phosphorus, usually via multicomponent fortifiers, has become common practice in most neonatal units caring for extremely low birth weight infants. To achieve extrauterine growth similar to intrauterine trajectories, very preterm infants require more protein than the amounts provided by breast milk [27].…”

Section: Discussionmentioning

confidence: 99%

Milk Curd Obstruction in Human Milk-Fed Preterm Infants

Longardt¹,

Loui²,

Bührer³

et al. 2019

Neonatology

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Background: Milk curd obstruction as a cause of intestinal obstruction has been known since 1959, but has nearly disappeared. However, in recent years it has experienced a revival in small premature infants. Objective: The aim of this study was to evaluate the clinical characteristics of milk curd obstruction (lactobezoar) in preterm infants. Methods: Data of preterm infants with milk curd obstruction cared for at a large tertiary neonatal intensive care unit between 2012 and 2016 were retrieved from the electronic registry and paper records. Results: A total of 10 infants (2 girls, 8 boys) were identified: the median birth weight was 595 g (range 270–922), gestational age was 24.4 weeks (23.4–27.0), weight-for-gestational age percentile was 16 (0–62), and age at diagnosis was 28 days (16–64). Five infants (50%) were small for gestational age. All neonates had received fortified human milk (added protein 2.0 g/100 mL, range 0–2.8; added calcium 2,400 µmol/100 mL, range 0–6 844; added phosphate 2,400 µmol/100 mL, range 0–5,178). Seven neonates underwent surgery, and 2 infants died. Hyperechoic masses in extended bowel loops, visualised by abdominal ultrasound, and pale/acholic faeces were hallmarks of milk curd obstruction. Conclusions: In this study, milk curd obstruction occurred exclusively in infants with a birth weight < 1,000 g (2.2%) and < 28 weeks’ gestational age (2.4%). Male and small for gestational age infants appeared to be at increased risk. Paying attention to the colour of the faeces of infants at risk might help to diagnose milk curd obstruction at an early stage.

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“…Five SRs (16,20,22,27,28) concluded that there was insu cient evidence to determine the effects of feeding supplementation on preterm infants of prebiotics (for prevention of hyperbilirubinaemia), carbohydrate, multi-nutrient, taurine, calcium, and phosphorus.…”

Section: Inconclusivementioning

confidence: 99%

“…In total, 160 quantitative primary studies were synthesised in the 17 SRs, all of which were RCTs or quasi-RCTs. Nine SRs (3,(13)(14)(15)(16)(17)(18)(19)(20) were published in the late 3 years (2018-2020), 5 SRs (21)(22)(23)(24)(25) were between year 2016 to year 2017 and only 3 SRs (26-28) were from year 2007, year 2010 and year 2014. , criteria 2 (duplicate study selection and data extraction), criteria 6 (characteristics of the included studies provided), criteria 7 (scienti c quality of the included studies assessed and documented), and criteria 8 (scienti c quality of the included studies used appropriately in formulating conclusions). The least met AMSTAR criteria was criteria 10 (likelihood of publication bias assessed) owing to the small number of the primary quantitative studies included in several SRs (3, 14, 16, 18-22, 27, 28).…”

Section: Characteristic and Quality Assessment Of Included Srsmentioning

confidence: 99%

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Effectiveness of Feeding Supplementation in Preterm Infants: An Overview of Systematic Reviews

Tao

Yang

et al. 2020

Preprint

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BackgroundPreterm infants have higher nutrition needs than term infants. The effectiveness of various feeding supplementation was assessed by the improvement of health outcomes in single specific systematic reviews (SRs). The aim of this review is to summarise these SRs to provide comprehensive evidence on the effectiveness of these interventions for preterm infants. MethodsA literature search was conducted in the PUBMED, EMBASE, Science Direct, Cochrane library, Web of Science, and Wiley online library. SR selection followed clear inclusion and exclusion criteria. Data extraction was performed by using the pre-designed tables and quality assessment was done by the AMSTAR tool. ResultsSeventeen SRs were included in the review. Fifteen kinds of feeding supplementation were reported in the SRs. The effectiveness of the interventions was defined as positive, having no impact, or inconclusive. Lactoferrin, probiotic, prebiotic, vitamin D, protein, and arginine were concluded to be positive; inositol, iodine, fat, glutamine, and long chain polyunsaturated fatty acid (LCPUFA) were concluded to have no impact; results for prebiotic (for prevention of hyperbilirubinaemia), carbohydrate, multi-nutrient, taurine, calcium, and phosphorus were inconclusive. All the SRs included were graded as being of high quality. ConclusionsSupplements with positive effects on health improvement were considerable to add to the feeding of preterm infants. More well-designed large RCTs are still needed to address the unsolved problems in the SRs concluded as having no impact or where the results were inconclusive.

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Calcium and phosphorus supplementation of human milk for preterm infants

Abstract: Calcium and phosphorus supplementation of human milk for preterm infants.

Cited by 17 publications

References 25 publications

Development of a human milk concentrate with human milk lyophilizate for feeding very low birth weight preterm infants: A preclinical experimental study

Development of a human milk concentrate with human milk lyophilizate for feeding very low birth weight preterm infants: A preclinical experimental study

Milk Curd Obstruction in Human Milk-Fed Preterm Infants

Effectiveness of Feeding Supplementation in Preterm Infants: An Overview of Systematic Reviews

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