Rickets in very low-birth-weight infants

Kulkarni, Prakash B.; Hall, Robert T.; Rhodes, Philip; Sheehan, Michael B.; Callenbach, John; Germann, Donald R.; Abramson, Sara J.

doi:10.1016/s0022-3476(80)80814-6

Cited by 90 publications

(29 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study, infants receiving early fortification had a significantly lower incidence of having an alkaline phosphatase level >500 starting at 33 weeks PMA. Elevated alkaline phosphatase levels and low serum phosphorus levels have been shown to be an early predictor of metabolic bone disease in premature infants 23,24 as well as a good predictor of length at 18 months and height at adolescence. 25,26 More recent data suggest that calcium and phosphorus supplementation does not need to necessarily match the high intrauterine accretion rates, suggesting that adaptation and stimulation, by the preterm infant itself, may provide part of the mineral requirements for postnatal bone formation.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of human milk fortification from the time of the first feeding: effects on infants of less than 31 weeks gestational age

2011

View full text Add to dashboard Cite

Objective: To determine whether human milk fortification from the time of the first feeding significantly improves weight gain and bone mineral status in infants of <31 weeks estimated gestational age as compared with delayed or standard human milk fortification.Study Design: This was a retrospective pre-post design. In all, 95 infants born at <31 weeks estimated gestational age were compared. There were 53 infants in the early fortification group (EFG) and 42 infants in the delayed fortification group (DFG). They were compared with regard to weight gain at 34 weeks postmenstrual age (PMA), and their serum levels of calcium, phosphorus and alkaline phosphatase levels were compared as an indicator of bone mineral status. The practice change of fortifying all human milk given to preterm infants at <34 weeks PMA commenced in June 2009. The usual practice of fortification took place once an infant had reached a feeding volume of 50 to 100 ml kg À1 per day. The new practice fortified all human milk with a powdered human milk fortifier to 24 calories per ounce, starting with the first feeding, no matter how small the volume.Result: There were no differences in weight gain between the EFG and the DFG. The group that received fortification from the time of the first feeding were significantly less likely to have alkaline phosphatase levels >500 U l À1 from 33 weeks PMA onward. There was no incidence of feeding intolerance with early fortification.Conclusion: Fortification of human milk from the time of the first feeding does not affect weight gain at 34 weeks PMA, but is related to a lower incidence of elevated alkaline phosphate levels and does not cause feeding intolerance.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of human milk fortification from the time of the first feeding: effects on infants of less than 31 weeks gestational age

2011

View full text Add to dashboard Cite

show abstract

“…42,[45][46][47][48] Average energy intakes in infants receiving soy protein-based formulas are equivalent to those achieved with cow milk formulas. 42 In infants fed soy protein-based formulas, the serum albumin concentration, as a marker of nutritional adequacy, is normal, 46,[49][50][51] and bone mineralization is equivalent to that documented with cow milk-based formulas in term infants. [5][6][7] Literature reviews and clinical studies of infants fed soy protein-based infant formulas raise no clinical concerns with respect to nutritional adequacy, sexual development, thyroid disease, immune function, or neurodevelopment.…”

Section: Use In Term and Preterm Infantsmentioning

confidence: 99%

“…54,55 As anticipated from these observations, the degree of osteopenia is increased in infants with low birth weight receiving soy proteinbased formulas. 50,56 Even with supplemental calcium and vitamin D, radiographic evidence of significant osteopenia was present in 32% of 125 preterm infants fed soy protein-based formula. 56 The cow milk protein-based formulas designed for preterm infants are clearly superior to soy protein-based formula for preterm infants.…”

Section: Use In Term and Preterm Infantsmentioning

confidence: 99%

Use of Soy Protein-Based Formulas in Infant Feeding

Bhatia¹,

Greer²

2008

Pediatrics

323

333

View full text Add to dashboard Cite

Soy protein-based formulas have been available for almost 100 years. Since the first use of soy formula as a milk substitute for an infant unable to tolerate a cow milk protein-based formula, the formulation has changed to the current soy protein isolate. Despite very limited indications for its use, soy protein-based formulas in the United States may account for nearly 25% of the formula market. This report reviews the limited indications and contraindications of soy formulas. It will also review the potential harmful effects of soy protein-based formulas and the phytoestrogens contained in these formulas.T HE AMERICAN ACADEMY of Pediatrics (AAP) is committed to the use of human milk as the ideal source of nutrition for infant feeding. However, by 2 months of age, the majority of infants in North America are receiving at least some formula. Soy-based infant formulas have been available for almost 100 years. 1 Despite limited indications, soy protein-based formula accounts for approximately 20% of the formula market in the United States. Because an infant formula provides a source of nutrition for an extended interval, its nutritional adequacy must be proven, and the indications for its use must be substantiated and well understood. This statement updates the 1998 AAP review of soy protein-based formulas and addresses the ongoing concern of phytoestrogens in soy formulas. COMPOSITIONIsolated soy protein-based formulas currently on the market are all free of cow milk protein and lactose and provide 67 kcal/dL. All are iron-fortified and meet the vitamin, mineral, and electrolyte specifications addressed in the 2004 guidelines from the AAP for feeding term infants 2 and established by the US Food and Drug Administration. 3 The protein is a soy isolate supplemented with L-methionine, L-carnitine, and taurine to provide a protein content of 2.45 to 2.8 g per 100 kcal or 1.65 to 1.9 g/dL. The fat content of soy protein-based formulas is derived primarily from vegetable oils. The quantity of specific fats varies by manufacturer and is usually similar to those in the manufacturer's corresponding cow milk-based formula. The fat content ranges from 5.02 to 5.46 g per 100 kcal or 3.4 to 3.6 g/dL. The oils used include soy, palm, sunflower, olein, safflower, and coconut. Docosahexaenoic and arachidonic acids now are added routinely.In formulas, carbohydrate sources are corn maltodextrin, corn syrup solids, and sucrose, with content ranging from 10.26 to 10.95 g per 100 kcal or 6.9 to 7.4 g/dL. Until 1980, mineral absorption from soy formulas was erratic because of poor stability of the suspensions and the presence of excessive soy phytates. 4 Because soy protein isolate formulas still contain 1.5% phytates, and up to 30% of the total phosphorus is phytate bound, they contain 20% more calcium and phosphorus than cow milk-based formulas and maintain the ratio of calcium to available phosphorus of 1.1 to 2.0:1. With the current formulations, bone mineralization, serum concentrations of calcium and phosphorus, and alka...

show abstract

“…Rickets is not uncommon in premature infants (7,23,31). Several factors are probably of pathogenetic importance (5,7,10,25,30), and deficient functions in all aspects of vitamin D metabolism have been implicated, such as: intestinal absorption (21, 31, 37), hepatic 25-hydroxylation (19,21,31), renal 1-hydroxylation (2 1, 3 l), and intestinal responsiveness to 1,25- Table 1.…”

mentioning

confidence: 99%