Rickets in very low-birth-weight infants born at Baragwanath Hospital.

[摘要] Disturbed mineral and bone metabolism is frequently found invery low-birth-weight infants fed breast-milk during thefirst three months of life. The study was designed to assessthe prevalence of this disturbed mineral homeostasis in avery low-birth-weight populatiun at Baragwanath Hospital andto determine whether the addition of a preterm infant formulato the feeds reduced the prevalence and increased the rate ofweight gain. Fifty three neonates weighing less than 1200gborn at Baragwanath Hospital were monitored for weight gain,growth and for biochemical and radiological evidence ofmetabolic bone disease. The infants were randomized toreceive either breast-milk only feeds or a combination ofbreast-milk and a premature formula in order to assess theeffect of the different feeds on the development of bonedisease. Weight gain and growth were similar in both groups.Calcium and phosphorus intakes were higher in the mixedfeeding group. However, serum calcium and phosphorus valueswere similar in the two groups throughout the study. Thebreast-milk group had significantly higher alkalinephosphatase levels. Radiological rickets was uncommun inboth groups, although periosteal reactions and osteopeniaoccurred frequently and with similar prevalence in bothgroups. Overt rickets is not a major problem in very-low birth-weight infants born at Baragwanath Hospital, althoughraised serum alkaline phosphatase values occur frequently.Feeding with breast-milk and a premature infant formula inequal proportions (as opposed to breast-milk only) does notappear to have any effect on weight gain and growth in verylow-birth-weight infants, but does partially prevent thepathological rise in alkaline phosphatase levels.

[发布机构] University of the Witwatersrand