Late Infantile Tetany and Secondary Hyperparathyroidism in Infants Fed Humanized Cow Milk Formula

Venkataraman, Pankaja S.

doi:10.1001/archpedi.1985.02140090026018

Cited by 45 publications

(25 citation statements)

References 16 publications

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“…[1][2][3][4][5][6][7]16 The effect is transient and occurs during the first weeks of life. The concern of increased risk of neonatal hypocalcemia has led infant formula companies to reduce the phosphorus content of the formula and to try to provide a formula with a calcium-to-phosphorus ratio more similar to that of human milk.…”

Section: Discussionmentioning

confidence: 99%

“…In infants, there are three reasons to suggest utilization of formulas that provide low but adequate phosphorus intake and a balanced ratio of calcium to phosphorus: (1) a low intestinal phosphorus concentration is an essential condition for generating an acid pH of the feces, which inhibits the growth of potentially pathogenic organisms; (2) the immature infantile kidney cannot readily excrete a surplus of phosphorus, and higher phosphorus intake during the neonatal period is a significant risk factor for hypocal-cemic tetany in both preterm 1 and full-term infants [2][3][4][5][6][7] ; and (3) high phosphorus and calcium intake in the newborn can result in metabolic acidosis secondary to a decreased renal capacity for acid excretion. It is thought that all three pathophysiologic mechanisms were effective in the biochemical evolution of humans, selecting women with low phosphorus milk and infants with a constantly high intestinal absorption rate of phosphorus.…”

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confidence: 99%

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Randomized Trial of Varying Mineral Intake on Total Body Bone Mineral Accretion During the First Year of Life

et al. 1997

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ABSTRACT.Objective. The effect of varying mineral intakes on total body bone mass accretion during the first year of life in healthy full-term infants is unknown. The purpose of this study was to determine whether total body bone mass accretion during the first year of life was influenced by the calcium and phosphorus intake of an infant and whether early differences in bone accretion persist through 1 year of age.Design. This prospective, randomized trial was conducted in two phases. In phase I, 67 infants were randomized within the first 2 weeks of life into either a low (439 mg of calcium per liter and 240 mg of phosphorus per liter) or moderate (510 mg of calcium per liter and 390 mg of phosphorus per liter) mineral-containing formula feeding group. An additional group of 34 human milkfed (low mineral) infants also was enrolled. Phase II involved an additional randomization of all infants at 6 months of age into moderate-mineral formula (see above), high-mineral formula (1350 mg of calcium per liter and 900 mg of phosphorus per liter), or cow milk (1230 mg of calcium per liter and 960 mg of phosphorus per liter) feeding group. Anthropometric measurements, nutrient intake, and total body bone mineral content (BMC) by dual-energy x-ray absorptiometry were measured at 1, 3, 6, 9, and 12 months.Results. During the first 6 months, the moderate-mineral group had a greater increase in weight (3.42 ؎ 0.62 kg) compared with the human milk group (2.93 ؎ 0.56 kg); the low-mineral group (3.19 ؎ 0.62 kg) was intermediate. Bone mass accretion differed in a similar direction, with the moderate-mineral feeding group having a greater increase than the human milk group and the low-mineral group being intermediate of the two. Including weight, length, and bone area as covariates, both the low-mineral formula-and human milk-fed groups had similar BMC, which was lower than that of the moderatemineral group at 3 and 6 months of age. Adjusted mean BMC values for the moderate-mineral formula-fed group compared with the low-mineral formula-and human milk-fed groups were 127.8 ؎ 1.5 (SEM) g vs 119.2 ؎ 1.5 and 122.1 ؎ 1.4 g, respectively, at 3 months of age and 168.7 ؎ 2.5 g vs 157.6 ؎ 2.5 and 158.7 ؎ 2.4 g, respectively, at 6 months of age. The BMC at 6 months of age among the formula-fed infants was correlated with both average dietary phosphorus intake (r ‫؍‬ .592) and average daily calcium intake (r ‫؍‬ .620) during the first 6 months. The relationships between BMC and these minerals remained significant even after controlling for caloric intake. It was not possible to determine the independent effects of dietary calcium and phosphorus on BMC because of the strong correlation of these minerals with each other. Despite significant differences in both calcium and phosphorus intakes during the second 6 months of life, there were no differences in growth parameters or bone mass accretion. Means for BMC, adjusted for body weight, length, and bone area, were not significantly different among feeding groups at either 9 or 12 months of ag...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Randomized Trial of Varying Mineral Intake on Total Body Bone Mineral Accretion During the First Year of Life

et al. 1997

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“…High serum phosphorus levels can have clinical consequences. Occasionally, hypocalcaemic tetany may occur in otherwise healthy term infants receiving a high phosphorus formula (Venkataraman et al 1985). Finally, a high phosphorus intake is a risk factor for the development of metabolic acidosis in high risk term infants (Kalhoff et al 1990).…”

Section: Minerals a N D Trace Elementsmentioning

confidence: 99%

The Composition of Human Milk as a Model for the Design of Infant Formulas: Recent Findings and Possible Applications

Goedhart

Bindels

1994

Nutr. Res. Rev.

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“…The major hypotheses tested were that during the neo¬ natal period, (1) serum calcium concentrations would be lower, and serum phosphorus and PTH concentrations higher, in neonates fed cow's milk-based formula com¬ pared with neonates fed human milk; and (2) neonates fed formula with a higher Ca/P ratio than that in standard in¬ fant formula would have calcium indices more similar to those in neonates fed human milk.…”

mentioning

confidence: 99%

Low Serum Calcium and High Parathyroid Hormone Levels in Neonates Fed 'Humanized' Cow's Milk—Based Formula

Specker

Tsang²,

Ho³

et al. 1991

Arch Pediatr Adolesc Med

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Late Infantile Tetany and Secondary Hyperparathyroidism in Infants Fed Humanized Cow Milk Formula

Cited by 45 publications

References 16 publications

Randomized Trial of Varying Mineral Intake on Total Body Bone Mineral Accretion During the First Year of Life

Randomized Trial of Varying Mineral Intake on Total Body Bone Mineral Accretion During the First Year of Life

The Composition of Human Milk as a Model for the Design of Infant Formulas: Recent Findings and Possible Applications

Low Serum Calcium and High Parathyroid Hormone Levels in Neonates Fed 'Humanized' Cow's Milk—Based Formula

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