Abstract
VLBW infants are prone to severe postnatal bone demineralisation owing to a high requirement (3.2mMol/10g weight gain) but a low absorption rate (15-50%) of Calcium (Ca) from formulas. The absorption can be compensated for by increasing the Ca intake. There is, however, concern about fat malabsorption and decreased weight gain because of a high Ca supplement.Methods: We therefore studied the weight gain of 70 VLBW infants (median birth weight 1020g, range 440-1485; median gestational age 28 weeks, range 24-32), who were supplemented individually by stepwise increasing an admixture of solid Ca-gluconate and Ca-glycerophosphate to the feedings until both Ca and Phosphate were excreted with urine (1-2mMol/l) (1). Infants were fed breast milk or preterm formula. The daily weight gain was calculated from 377 6-day periods and correllated to the average daily Ca intake (milk + supplement) these periods. Infants were studied for 30 days (median) (range 6-66 days). Postmenstrual age at the time of the study was 35 weeks (median) (range 29-43).Results: Linear regression analysis did not show any evidence that weight gain (median 20.8 g/day) was reduced by increased Ca intake within the range of 1.3 - 19 mMol/kg×day (median 6.4). Regression line was y(g/day) = 0.00137×(mMol Ca/kg×day) +19.9. No case of necrotizing enterocolitis or intestinal obstruction occurred.Conclusion: Individual supplementation of VLBW infants with solid Ca-gluconate and Ca-glycerophosphate does not impair weight gain, is well tolerated and effects bone mineralisation identical to in utero as has been shown earlier (1).
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