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Calcium, phosphorus and magnesium balance: FM 85 fortification of human milk does not meet mineral needs of extremely low birthweight infants

European Journal of Clinical Nutrition volume 56, pages 228–235 (2002)Cite this article

Abstract

Objective: Extremely low birthweight (<1000 g) infants are growing rapidly and their nutritional requirements for calcium, phosphorus, magnesium are high.

Design: Prospective, mineral balance.

Setting: The study was carried out at the Department of Neonatology, Virchow-Hospital, Charité Berlin and the Department of Molecular Trace Element Research, Hahn-Meitner-Institute Berlin.

Subjects: Nineteen infants <1000 g birthweight were admitted, nine infants dropped out and 10 infants (birthweight 730–995 g), fed fortified human milk were included.

Intervention: We collected infant's urine and feces for 72 h, a sample of human milk and infant's blood at 7 and 12 weeks of age. Elements were measured by inductively coupled plasma atomic emission spectrophotometry.

Results: Mean (s.d.) mineral concentration in milk was low especially at 12 weeks: calcium 9.88 (±3.58) mmol/l, phosphorus 7.02 (±3.81) mmol/l, magnesium 1.59 (±0.54) mmol/l. Calcium retention was minimal or negative during the study, whereas phosphorus and magnesium balances were positive. Caffeine and diuretics increased mineral excretion. Serum alkaline phosphatase was mostly <800 U/l, and 162 U/l in one infant with zinc deficiency at 12 weeks. Alkaline phosphatase correlated with absorption and retention of phosphorus, and with longitudinal growth.

Conclusions: Infants <1000 g have high nutritional needs for calcium, phosphorus and magnesium, which are not met by a human milk fortifier widely used in Europe. Controlled trials are needed to assess requirements, duration and risks of mineral supplementation.

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  1. A Loui: Guarantor: A Loui.

  2. A Loui, A Raab, M Obladen and P Brätter: Contributors: A Loui, A Raab, M Obladen and P Brätter.

Authors and Affiliations

  1. Department of Neonatology, Charité Virchow-Hospital, Humboldt University Berlin, Germany

    A Loui & M Obladen

  2. Department of Molecular Trace Element Research, Hahn-Meitner Institute Berlin, Germany

    A Raab & P Brätter

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  1. A Loui
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  2. A Raab
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Correspondence to A Loui.

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Loui, A., Raab, A., Obladen, M. et al. Calcium, phosphorus and magnesium balance: FM 85 fortification of human milk does not meet mineral needs of extremely low birthweight infants. Eur J Clin Nutr 56, 228–235 (2002). https://doi.org/10.1038/sj.ejcn.1601305

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