Efficacy of calcium glycerophosphate vs conventional mineral salts for total parenteral nutrition in low-birth-weight infants: a randomized clinical trial

Article Abstract:

Many low-birth-weight infants require intensive care that includes total parenteral nutrition (TPN, intravenous feeding). However, the conventional mineral salts that are used in TPN formulas have poor solubility and are not retained very well in the body. Because of this, it is possible for infants receiving TPN to develop calcium and phosphorus deficiencies. Studies have reported that infants who require long-term TPN develop osteopenia (reduced bone mass or density) and are susceptible to bone fractures. Calcium glycerophosphate (CaGlyP) is a mineral salt that is very soluble and it has been shown to increase bone mass in early-weaned piglets. Therefore, a study was performed to compare CaGlyP with conventional mineral salts, calcium gluconate with potassium phosphate (CaGluc+P), in providing an adequate supply of minerals for low-birth-weight infants requiring long-term TPN. Nine low-birth-weight infants received TPN with CaGluc+P, while seven received TPN with CaGlyP. The amounts of calcium and phosphorus retained in the body and excreted in the urine were measured following treatment with TPN. The amounts of acid in the urine and of osteocalcin (a protein made in the bone) in the blood were used to identify changes in bone mass. The amount of calcium and phosphorus retained in the body and excreted in the urine, the amount of acid in the urine, and the amount of osteocalcin in the blood were the same for both types of TPN. Since CaGlyP is more soluble than CaGluc+P, larger amounts of CaGlyP may be used and this may enhance mineral retention in the body and promote bone growth in low-birth-weight infants requiring TPN. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Bones, Parenteral feeding, Parenteral nutrition, Growth, Nutritional aspects, Minerals (Nutrients), Calcium in the body, Calcium (Nutrient), Minerals in human nutrition, Phosphorus in the body, Phosphorus (Nutrient), Bone development

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How much vitamin D for neonates?

Article Abstract:

To learn more about the optimal dose of vitamin D (critical for the formation of normal bone) for newborn infants, a study was carried out in 27 low-birth-weight, premature infants in good health and in 25 healthy full-term infants. The subjects were randomly assigned to receive one of four vitamin D doses daily and their blood was sampled at regular intervals to determine the concentrations of parathyroid hormone (which helps regulate the movement of calcium into and out of bone), calcium, phosphorus, and other factors. The study continued from birth until the infants reached 16 weeks of age. The four doses were: 10 or 20 micrograms per day (400 or 800 units per day) of vitamin D, or 0.85 or 1.5 micrograms per day of 25-hydroxyvitamin D3 (also called calcidiol; the major circulating form of vitamin D and one of its metabolic precursors). The levels of all substances measured in the four experimental conditions during the study are presented in tabular form. The results indicate, based on blood levels of vitamin D, that 10 micrograms per day, or 400 International Units, are sufficient for premature and full-term well infants. However, while the lower dose of 25-hydroxyvitamin D provided enough vitamin D for the low-birth-weight infants, it was not enough to maintain proper levels in the full-term babies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Vitamin D

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Partition of nitrogen intake and excretion in low-birth-weight infants

Article Abstract:

The normal full-term infant's nutritional needs are adequately met by the human milk. The premature infant, however, has nutritional needs even greater than those of the full-term infant. It is questionable whether the higher energy, protein and mineral needs of the preterm infant are adequately met by full-term human milk. The milk of mothers delivering preterm infants, preterm milk (PTM), is higher in nitrogen, protein, mineral energy and electrolytes. Nitrogen in human milk can come in a protein and nonprotein form. Protein nitrogen is important to help fight bacteria and viruses. Nonprotein nitrogen, although less understood, may help to produce amino acids in the body. The results of feeding PTM or a combination of half PTM and half infant formula were studied in regard to the balance of nitrogen in the body among 24 low-birth-weight infants. The intake and output of nitrogen in the urine was measured over a 72-hour period. There was no difference between the amount of nitrogen absorbed and retained between the two groups. Preterm milk given to preterm infants produced a nitrogen balance similar to that found in fetuses growing normally during the first five weeks of life. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Evaluation, Breast milk, Milk, Nitrogen metabolism, Protein nitrogen

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