The long-term effect of early mineral, vitamin D, and breast milk intake on bone mineral status in 9-to 11-year-old children born prematurely

Background: Although the short-term benefits of mineral supplementation in preterm infants has been established, the long-term benefits are less clear . The purpose of the study was to evaluate effects of early-life mineral, v itamin D, and boast milk intake on bone mineral status in children 9 to 11 years of age who were born prematurely. Methods: seventy preterm infants born 1985 through 1987 were randomized int o four groups: to receive a vitamin D dose of 500 or 1000 IU/day and calciu m- and phosphorus-supplemented or unsupplemented breast milk. At 3 months o f age, radial bone mineral content was determined by single-photon absorpti ometry and vitamin D metabolites were assessed. At 9 to 11 years of age, th e bone mineral status of the radius and lumbar spine was assessed using dua l energy x-ray absorptiometry. Results: At the age of 3 months, the preterm infants with diets supplemente d with minerals had 36% higher bone mineral con-tent than the preterm infan ts whose diet was not supplemented with minerals. At the age of 9 to Il yea rs, in contrast, bone mineral status was comparable among the groups, irres pective of different mineral supplementation during the neonatal period. in terestingly, the lumbar bone mineral apparent density was positively relate d to lactation in mineral-supplemented children. There was neither short-te rm nor long-term benefit to bone mineral status of a vitamin D dose of 1000 IU/day compared with 500 IU/day. Conclusions: The short-term benefit to bone mineral density in preterm infa nts of mineral supplementation of the early diet is obvious, but, in the lo ng term, the effects seem to disappear. The results also imply that a relat ively long period of breastfeeding may be needed to optimize long-term bone mineral acquisition in the lumbar spine.