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

Specker, Bonny; Tsang, Reginald C.; Ho, Mona; Landi, Theresa M.; Gratton, Teresa L.

doi:10.1001/archpedi.1991.02160080119033

Cited by 16 publications

(19 citation statements)

References 13 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%

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%

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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“…After 6 weeks, serum phosphorus in these phosphorus-rich-formula-fed infants decreased to levels similar to those of their human-milk-fed counterparts, with no apparent toxicity or significant differences in bone mineral content, weight, or length. However, some studies have suggested that infants less than 1 months may be at increased risk of hypocalcemia and late neonatal hypocalcemic tetany when fed modified cow milk formulas with high phosphorus content (37, 152, 164). …”

Section: Phosphorus Requirements Across the Life Cyclementioning

confidence: 99%

Dietary Phosphorus Intake and the Kidney

Chang

Anderson

2017

Annu. Rev. Nutr.

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Although phosphorus is an essential nutrient required for multiple physiological functions, recent research raises concerns that high phosphorus intake could have detrimental effects on health. Phosphorus is abundant in the food supply of developed countries, occurring naturally in protein-rich foods and as an additive in processed foods. High phosphorus intake can cause vascular and renal calcification, renal tubular injury, and premature death in multiple animal models. Small studies in human suggest that high phosphorus intake may result in positive phosphorus balance and correlate with renal calcification and albuminuria. Although serum phosphorus is strongly associated with cardiovascular disease, progression of kidney disease, and death, limited data exist linking high phosphorus intake directly to adverse clinical outcomes. Further prospective studies are needed to determine whether phosphorus intake is a modifiable risk factor for kidney disease.

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“…The ratio of calcium to phosphorus in human milk is about 2:1 on a weight basis or about 1.6:1 on a molar basis (Specker et al, 1991;Steichen and Koo, 1992).…”

Section: Calcium Content Of Human Milkmentioning

confidence: 99%

Scientific Opinion on the essential composition of infant and follow-on formulae

Products¹

2014

EFSA Journal

273

124

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Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver a scientific opinion on the essential composition of infant and follow-on formula. This opinion reviews the opinion provided by the Scientific Committee on Food in 2003 on the essential requirements of infant and follow-on formulae in light of more recent evidence and by considering the Panel's opinion of October 2013 on nutrient requirements and dietary intakes of infants and young children in the European Union. The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first six months of life in its previous opinion and an average amount of formula consumed during this period. From a nutritional point of view, the minimum contents of nutrients in infant and follow-on formula proposed by the Panel cover the nutritional needs of virtually all healthy infants born at term and there is no need to exceed these amounts in formulae, as nutrients which are not used or stored have to be excreted and this may put a burden on the infant's metabolism. Therefore, the Panel emphasises that maximum amounts should be interpreted not as target values but rather as upper limits of a range which should not be exceeded. There is scientific consensus that breast milk is the preferred food for all healthy infants and provides an adequate supply of all nutrients to support growth and development (with the exception of vitamin K during the first weeks of life and of vitamin D). Whereas the composition of infant formula remains stable over time, breast milk composition changes continuously and therefore infant formula cannot imitate breast milk. © EuropeanAll formulae intended for infants must be safe and suitable to meet the nutritional requirements and promote growth and development of infants born at term when used as a sole source of nutrition during the first months of life, and when used as the principal liquid element in a progressively diversified diet after the introduction of appropriate complementary feeding. Nutrients and substances should be added to formulae for infants only in amounts that serve a nutritional or other benefit. The addition in amounts higher than those serving a benefit or the inclusion of unnecessary substances in formulae may put a burden on the infant's metabolism and/or on other physiological functions, as substances which are not used or stored have to be excreted.The minimum content of a nutrient in formula proposed in this opinion is derived from the intake levels the Panel had considered adequate for the majority of infants in the first half of the first year of life in its previous opinion and an average amount of daily energy intake from formula during this period (500 kcal/day). These minimum amounts should be understood as target values which cover the nutritional needs of virtually all infants born at term for optimal growth and devel...

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

Cited by 16 publications

References 13 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

Dietary Phosphorus Intake and the Kidney

Scientific Opinion on the essential composition of infant and follow-on formulae

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