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Update on Calcium and Phosphorus Requirements of Preterm Infants and Recommendations for Enteral Mineral Intake

Background: With current Ca and P recommendations for enteral nutrition, preterm infants, especially VLBW, fail to achieve a bone mineral content (BMC) equivalent to term infants. During the first 3 years, most notably in light at term equivalent age (<−2 Z score) VLBW infants’ BMC does not catch...

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Autores principales: Mihatsch, Walter, Thome, Ulrich, Saenz de Pipaon, Miguel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8146348/
https://www.ncbi.nlm.nih.gov/pubmed/33925281
http://dx.doi.org/10.3390/nu13051470
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author Mihatsch, Walter
Thome, Ulrich
Saenz de Pipaon, Miguel
author_facet Mihatsch, Walter
Thome, Ulrich
Saenz de Pipaon, Miguel
author_sort Mihatsch, Walter
collection PubMed
description Background: With current Ca and P recommendations for enteral nutrition, preterm infants, especially VLBW, fail to achieve a bone mineral content (BMC) equivalent to term infants. During the first 3 years, most notably in light at term equivalent age (<−2 Z score) VLBW infants’ BMC does not catch up. In adults born preterm with VLBW or SGA, lower adult bone mass, lower peak bone mass, and higher frequency of osteopenia/osteoporosis have been found, implying an increased risk for future bone fractures. The aim of the present narrative review was to provide recommendation for enteral mineral intake for improving bone mineral accretion. Methods: Current preterm infant mineral recommendations together with fetal and preterm infant physiology of mineral accretion were reviewed to provide recommendations for improving bone mineral accretion. Results: Current Ca and P recommendations systematically underestimate the needs, especially for Ca. Conclusion: Higher enteral fortifier/formula mineral content or individual supplementation is required. Higher general mineral intake (especially Ca) will most likely improve bone mineralization in preterm infants and possibly the long-term bone health. However, the nephrocalcinosis risk may increase in infants with high Ca absorption. Therefore, individual additional enteral Ca and/or P supplementations are recommended to improve current fortifier/formula mineral intake.
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spelling pubmed-81463482021-05-26 Update on Calcium and Phosphorus Requirements of Preterm Infants and Recommendations for Enteral Mineral Intake Mihatsch, Walter Thome, Ulrich Saenz de Pipaon, Miguel Nutrients Review Background: With current Ca and P recommendations for enteral nutrition, preterm infants, especially VLBW, fail to achieve a bone mineral content (BMC) equivalent to term infants. During the first 3 years, most notably in light at term equivalent age (<−2 Z score) VLBW infants’ BMC does not catch up. In adults born preterm with VLBW or SGA, lower adult bone mass, lower peak bone mass, and higher frequency of osteopenia/osteoporosis have been found, implying an increased risk for future bone fractures. The aim of the present narrative review was to provide recommendation for enteral mineral intake for improving bone mineral accretion. Methods: Current preterm infant mineral recommendations together with fetal and preterm infant physiology of mineral accretion were reviewed to provide recommendations for improving bone mineral accretion. Results: Current Ca and P recommendations systematically underestimate the needs, especially for Ca. Conclusion: Higher enteral fortifier/formula mineral content or individual supplementation is required. Higher general mineral intake (especially Ca) will most likely improve bone mineralization in preterm infants and possibly the long-term bone health. However, the nephrocalcinosis risk may increase in infants with high Ca absorption. Therefore, individual additional enteral Ca and/or P supplementations are recommended to improve current fortifier/formula mineral intake. MDPI 2021-04-27 /pmc/articles/PMC8146348/ /pubmed/33925281 http://dx.doi.org/10.3390/nu13051470 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Mihatsch, Walter
Thome, Ulrich
Saenz de Pipaon, Miguel
Update on Calcium and Phosphorus Requirements of Preterm Infants and Recommendations for Enteral Mineral Intake
title Update on Calcium and Phosphorus Requirements of Preterm Infants and Recommendations for Enteral Mineral Intake
title_full Update on Calcium and Phosphorus Requirements of Preterm Infants and Recommendations for Enteral Mineral Intake
title_fullStr Update on Calcium and Phosphorus Requirements of Preterm Infants and Recommendations for Enteral Mineral Intake
title_full_unstemmed Update on Calcium and Phosphorus Requirements of Preterm Infants and Recommendations for Enteral Mineral Intake
title_short Update on Calcium and Phosphorus Requirements of Preterm Infants and Recommendations for Enteral Mineral Intake
title_sort update on calcium and phosphorus requirements of preterm infants and recommendations for enteral mineral intake
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8146348/
https://www.ncbi.nlm.nih.gov/pubmed/33925281
http://dx.doi.org/10.3390/nu13051470
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