MODERATE NUTRIENT SUPPLEMENTATION OF MOTHERS MILK FOR PRETERM INFANTSSUPPORTS ADEQUATE BONE MASS AND SHORT-TERM GROWTH - A RANDOMIZED, CONTROLLED TRIAL

Our objectives were 1) to determine whether moderate nutrient suppleme ntation of mother's milk (MM) for preterm infants, in the form of a ne w multinutrient fortifier (MNF), would improve short-term growth and b one mineral content (BMC) when compared with supplementation with calc ium and phosphorus alone; and 2) to investigate whether moderate calci um and phosphorus intakes, in the form of calcium glycerophosphate (Ca GP), resulted in a BMC similar to that of term corrected infants. Twen ty-five preterm infants fed MM were randomly assigned to receive eithe r MM+MNF or MM+CaGP, A third group of infants fed preterm formula (PTF ) served as a comparison group. Whole-body BMC and lean and fat mass w ere determined by dual-energy X-ray absorptiometry (DXA) at full-term age, Nitrogen retention and calcium, phosphorus, and zinc intakes were determined by using mass balance techniques. Nitrogen retention was s ignificantly lower in the MM+CaGP group than in the PTF group as were both weight and length gain (weight gain: 16.6 +/- 1.6, 14.2 +/- 2.0, and 16.1 +/- 2.9 g . kg(-1) . d(-1); length gain: 1.1 +/- 0.2, 0.9 +/- 0.2, and 1.1 +/- 0.3 cm/wk for the MM+MNF, MM+CaGP, and PTF groups, r espectively). Biochemical indexes of mineral status and bone turnover were normal. Conservative amounts of calcium and phosphorus, as CaGP, resulted in adequate BMC. Moderate amounts of protein, calcium, and ph osphorus plus trace elements added to MM in the form of an MNF resulte d in improved linear growth but did not provide any advantages to BMC when compared with supplementation with calcium and phosphorus alone.