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Growth and Phosphorus Metabolism in Premature Infants Fed Human Milk, Fortified Human Milk, or Special Premature Formula: Use of Serum Procollagen as a Marker of Growth

Growth and Phosphorus Metabolism in Premature Infants Fed Human Milk, Fortified Human Milk, or... Abstract • Human milk promotes less than optimal growth and is associated with phosphorus deficiency and decreased bone mineralization in very-low-birth-weight (VLBW) infants. In this study, the effects of feeding premature infants either human milk (HM), fortified human milk (FHM), or special premature formula (Similac Special Care [SSC]) on growth, phosphorus metabolism, and serum type I procollagen (pColl-I-C) were evaluated. Infants fed FHM exhibited a rate of weight gain and an increase in head circumference comparable with infants fed SSC and significantly greater than infants fed HM, despite the fact that both the FHM group and the HM group demonstrated biochemical evidence of phosphorus deficiency. The pColl-I-C concentrations in VLBW infants were tenfold to 20-fold greater than concentrations in normal children older than 2 years of age. The pColl-I-C levels correlated positively with weight gain and Were significantly greater in the FHM and SSC groups than in the HM group. By contrast, serum alkaline phosphatase levels did not correlate with weight gain and were significantly lower in the rapidly growing SSC group than in either of the two groups with phosphorus deficiency and presumed poor bone mineralization. We conclude that the serum pColl-I-C concentration is a biochemical marker of growth in VLBW infants and may prove useful as a predictor of growth responses to various nutritional and therapeutic interventions. (AJDC 1987;141:511-515) References 1. American Academy of Pediatrics Committee on Nutrition: Nutritional needs of the low-birth weight infant . Pediatrics 1985;75:976-984. 2. Putet G, Senterre J, Rigo J, et al: Nutritional balance, energy utilization, and composition of weight gain in very-low-birth-weight infants fed pooled human milk or a preterm formula . J Pediatr 1984;105:79-85.Crossref 3. Fleishman AR, Finberg L: Breast milk for term and preterm infants: Optimal nutrition? Semin Perinatol 1979;3:397-405. 4. Schanler RJ, Garza C, Nichols CL: Fortified mother's milk for very-low-birth-weight infants: Results of growth and nutrient balance studies . J Pediatr 1985;107:437-445.Crossref 5. Greer FR, Tsang RC: Calcium, phosphorus, magnesium and vitamin D requirements for the preterm infant , in Tsang RC (ed): Vitamin and Mineral Requirements in Preterm Infants . New York, Marcel Dekker Inc, 1985, pp 99-136. 6. Welsh JK, May JT: Anti-infective properties of breast milk . J Pediatr 1979;94:1-9.Crossref 7. Pittard WB III: Breast milk immunology: A frontier in infant nutrition . AJDC 1979;133:83-87. 8. Stein H, Cohen D, Herman AAB, et al: Pooled pasteurized breast milk and untreated own mother's milk in the feeding of very low birth weight babies: A randomized controlled trial . J Pediatr Gastroenterol Nutr 1986;5:242-247.Crossref 9. Tyson JE, Lasky RE, Mize CE, et al: Growth, metabolic response and development in very-low-birth-weight infants fed banked human milk or enriched formula: I. Neonatal findings . J Pediatr 1983;103:95-104.Crossref 10. Chan GM, Mileur L, Hansen JW: Effects of increased calcium formulas and human milk on bone mineralization in preterm infants . J Pediatr Gastroenterol Nutr 1986;5:444-449.Crossref 11. Greer FR, McCormick A, Loker J: Improved bone mineral content (BMC) without correction of urinary signs of phosphate deficiency syndrome' in preterm infants fed own mother's fortified milk , abstracted. Clin Res 1984;32: 806. 12. Rowe JC, Wood DW, Rowe DW, et al: Nutritional hypophosphatemic rickets in a premature infant fed breast milk . N Engl J Med 1979;300:293-295.Crossref 13. Rowe J, Rowe D, Horak E, et al: Hypophosphatemia and hypercalciuria in small premature infants fed human milk: Evidence for inadequate dietary phosphorus . J Pediatr 1984;104:112-117.Crossref 14. Bhatia J, Fomon SJ: Formula for premature infants: Fate of calcium and phosphorus . Pediatrics 1985;72:37-40. 15. Baginski ES, Marie SS, Clark WL, et al: Direct microdetermination of serum calcium . Clin Chim Acta 1973;46:49-54.Crossref 16. Gomori G: A modification of the colorimetric phosphorus determination for use with the photoelectric colorimeter . J Lab Clin Med 1942;27:955-960. 17. Larsen K: Creatinine assay by a reactionkinetic principle . Clin Chim Acta 1972;41: 209-217.Crossref 18. Bowers GN, McComb RB: Measurement of total alkaline phosphatase activity in human serum . Clin Chem 1975;21:1988-1995. 19. Taubman MB, Goldberg B, Sherr CJ: Radioimmunoassay for human procollagen . Science 1974;186:1115-1117.Crossref 20. Carey DE, Goldberg B, Ratzan SK, et al: Serum immunoreactive procollagen levels in growth hormone deficient children before and during treatment with growth hormone . Pediatr Res 1985;19:8-11.Crossref 21. De la Huerga J, J, Smetters GW, GW, Sherrick JC: JC: Colorimetric determination of serum proteins: The biuret reaction , in Sunderman FW, Sunderman FW Jr (eds): Serum Proteins and Dysproteinemias . New York, JB Lippincott, 1964, PP 56-62. 22. Grant GH, Kachmar JF: The proteins of body22. fluids , in Tietz NW (ed): The of Clinical Chemistry . Philadelphia, WB Saunders Co, 1976, pp 298-376. 23. Kaplan A, Savory J: Evaluation of cellulose-acetate electrophoresis system for serum protein fractionation . Clin Chem 1965;11:937-942. 24. Association of Official Analytical Chemists 1980: Official Methods of Analysis , ed 13. Baltimore, Monotypes Composition Co, 1980, p 858. 25. Anderson GH, Atkinson SA, Bryant MH: Energy and macronutrient content of human milk during early lactation from mothers giving birth prematurely and at term . Am J Clin Nutr 1981;34:258-265. 26. Gross SJ: Growth and biochemical response of preterm infants fed human milk or modified infant formula . N Engl J Med 1983;308: 237-241.Crossref 27. Atkinson SA, Radde IC, Anderson GH: Macromineral balances in premature infants fed their own mother's milk or formula . J Pediatr 1983;102:99-106.Crossref 28. Greer FR, Steichen JJ, Tsang RC: Calcium and phosphate supplements in breast milk-related rickets . AJDC 1982;136:581-583. 29. Sagy M, Birenbaum E, Balin A, et al: Phosphate-depletion syndrome in a premature infant fed human milk . J Pediatr 1980;96:683-685.Crossref 30. Lee DBN, Brautbar N, Walling NW, et al: The biochemical indices of experimental phosphorus depletion (PD): A re-examination of their physiological implications . Adv Exp Med Biol 1978;103:381-394. 31. Ricour C, Millot M, Balsan S: Phosphorus depletion in children on long-term parenteral nutrition . Ada Paediatr Scand 1975;64:385-392.Crossref 32. Pettifor JM, Stein H, Herman A, et al: Mineral homeostasis in very-low-birth-weight infants fed own mother's milk or pooled pasteurized preterm milk . J Pediatr Gastroenterol Nutr 1986;5:248-253.Crossref 33. Kovar I, Mayne P, Barltrop D: Plasma alkaline phosphatase activity: A screening test for rickets in preterm infants . Lancet 1982;1: 308-310.Crossref 34. Bornstein P, Byers PH: Disorders of collagen metabolism , in Bondy PK, Rosenberg LE (eds): Metabolic Control and Disease . Philadelphia, WB Saunders Co, 1980, pp 1089-1153. 35. Fleischmajer R, Timpl R, Tuderman L, et al: Ultrastructural identification of extension amino-propeptides of type I and III collagens in human skin . Proc Natl Acad Sci USA 1981;78: 7360-7364.Crossref 36. Fleischmajer R, Olsen BR, Timpl R, et al: Collagen fibril formation during embryogenesis . Proc Natl Acad Sci USA 1983;80:3354-3358.Crossref 37. Carey DE, Goldberg B, Ratzan SK, et al: Serum immunoreactive procollagen levels in children with growth hormone deficiency and hypothyroidism , abstracted. Pediatr Res 1982;16: 135A. 38. Hyams JS, Carey DE, Leichtner AM, AM, et al: Type I procollagen as a biochemical marker of growth in children with inflammatory bowel disease . J Pediatr 1986;109:619-624.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Growth and Phosphorus Metabolism in Premature Infants Fed Human Milk, Fortified Human Milk, or Special Premature Formula: Use of Serum Procollagen as a Marker of Growth

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1987.04460050053029
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Abstract

Abstract • Human milk promotes less than optimal growth and is associated with phosphorus deficiency and decreased bone mineralization in very-low-birth-weight (VLBW) infants. In this study, the effects of feeding premature infants either human milk (HM), fortified human milk (FHM), or special premature formula (Similac Special Care [SSC]) on growth, phosphorus metabolism, and serum type I procollagen (pColl-I-C) were evaluated. Infants fed FHM exhibited a rate of weight gain and an increase in head circumference comparable with infants fed SSC and significantly greater than infants fed HM, despite the fact that both the FHM group and the HM group demonstrated biochemical evidence of phosphorus deficiency. The pColl-I-C concentrations in VLBW infants were tenfold to 20-fold greater than concentrations in normal children older than 2 years of age. The pColl-I-C levels correlated positively with weight gain and Were significantly greater in the FHM and SSC groups than in the HM group. By contrast, serum alkaline phosphatase levels did not correlate with weight gain and were significantly lower in the rapidly growing SSC group than in either of the two groups with phosphorus deficiency and presumed poor bone mineralization. We conclude that the serum pColl-I-C concentration is a biochemical marker of growth in VLBW infants and may prove useful as a predictor of growth responses to various nutritional and therapeutic interventions. (AJDC 1987;141:511-515) References 1. American Academy of Pediatrics Committee on Nutrition: Nutritional needs of the low-birth weight infant . Pediatrics 1985;75:976-984. 2. Putet G, Senterre J, Rigo J, et al: Nutritional balance, energy utilization, and composition of weight gain in very-low-birth-weight infants fed pooled human milk or a preterm formula . J Pediatr 1984;105:79-85.Crossref 3. Fleishman AR, Finberg L: Breast milk for term and preterm infants: Optimal nutrition? Semin Perinatol 1979;3:397-405. 4. Schanler RJ, Garza C, Nichols CL: Fortified mother's milk for very-low-birth-weight infants: Results of growth and nutrient balance studies . J Pediatr 1985;107:437-445.Crossref 5. Greer FR, Tsang RC: Calcium, phosphorus, magnesium and vitamin D requirements for the preterm infant , in Tsang RC (ed): Vitamin and Mineral Requirements in Preterm Infants . New York, Marcel Dekker Inc, 1985, pp 99-136. 6. Welsh JK, May JT: Anti-infective properties of breast milk . J Pediatr 1979;94:1-9.Crossref 7. Pittard WB III: Breast milk immunology: A frontier in infant nutrition . AJDC 1979;133:83-87. 8. Stein H, Cohen D, Herman AAB, et al: Pooled pasteurized breast milk and untreated own mother's milk in the feeding of very low birth weight babies: A randomized controlled trial . J Pediatr Gastroenterol Nutr 1986;5:242-247.Crossref 9. Tyson JE, Lasky RE, Mize CE, et al: Growth, metabolic response and development in very-low-birth-weight infants fed banked human milk or enriched formula: I. Neonatal findings . J Pediatr 1983;103:95-104.Crossref 10. Chan GM, Mileur L, Hansen JW: Effects of increased calcium formulas and human milk on bone mineralization in preterm infants . J Pediatr Gastroenterol Nutr 1986;5:444-449.Crossref 11. Greer FR, McCormick A, Loker J: Improved bone mineral content (BMC) without correction of urinary signs of phosphate deficiency syndrome' in preterm infants fed own mother's fortified milk , abstracted. Clin Res 1984;32: 806. 12. Rowe JC, Wood DW, Rowe DW, et al: Nutritional hypophosphatemic rickets in a premature infant fed breast milk . N Engl J Med 1979;300:293-295.Crossref 13. Rowe J, Rowe D, Horak E, et al: Hypophosphatemia and hypercalciuria in small premature infants fed human milk: Evidence for inadequate dietary phosphorus . J Pediatr 1984;104:112-117.Crossref 14. Bhatia J, Fomon SJ: Formula for premature infants: Fate of calcium and phosphorus . Pediatrics 1985;72:37-40. 15. Baginski ES, Marie SS, Clark WL, et al: Direct microdetermination of serum calcium . Clin Chim Acta 1973;46:49-54.Crossref 16. Gomori G: A modification of the colorimetric phosphorus determination for use with the photoelectric colorimeter . J Lab Clin Med 1942;27:955-960. 17. Larsen K: Creatinine assay by a reactionkinetic principle . Clin Chim Acta 1972;41: 209-217.Crossref 18. Bowers GN, McComb RB: Measurement of total alkaline phosphatase activity in human serum . Clin Chem 1975;21:1988-1995. 19. Taubman MB, Goldberg B, Sherr CJ: Radioimmunoassay for human procollagen . Science 1974;186:1115-1117.Crossref 20. Carey DE, Goldberg B, Ratzan SK, et al: Serum immunoreactive procollagen levels in growth hormone deficient children before and during treatment with growth hormone . Pediatr Res 1985;19:8-11.Crossref 21. De la Huerga J, J, Smetters GW, GW, Sherrick JC: JC: Colorimetric determination of serum proteins: The biuret reaction , in Sunderman FW, Sunderman FW Jr (eds): Serum Proteins and Dysproteinemias . New York, JB Lippincott, 1964, PP 56-62. 22. Grant GH, Kachmar JF: The proteins of body22. fluids , in Tietz NW (ed): The of Clinical Chemistry . Philadelphia, WB Saunders Co, 1976, pp 298-376. 23. Kaplan A, Savory J: Evaluation of cellulose-acetate electrophoresis system for serum protein fractionation . Clin Chem 1965;11:937-942. 24. Association of Official Analytical Chemists 1980: Official Methods of Analysis , ed 13. Baltimore, Monotypes Composition Co, 1980, p 858. 25. Anderson GH, Atkinson SA, Bryant MH: Energy and macronutrient content of human milk during early lactation from mothers giving birth prematurely and at term . Am J Clin Nutr 1981;34:258-265. 26. Gross SJ: Growth and biochemical response of preterm infants fed human milk or modified infant formula . N Engl J Med 1983;308: 237-241.Crossref 27. Atkinson SA, Radde IC, Anderson GH: Macromineral balances in premature infants fed their own mother's milk or formula . J Pediatr 1983;102:99-106.Crossref 28. Greer FR, Steichen JJ, Tsang RC: Calcium and phosphate supplements in breast milk-related rickets . AJDC 1982;136:581-583. 29. Sagy M, Birenbaum E, Balin A, et al: Phosphate-depletion syndrome in a premature infant fed human milk . J Pediatr 1980;96:683-685.Crossref 30. Lee DBN, Brautbar N, Walling NW, et al: The biochemical indices of experimental phosphorus depletion (PD): A re-examination of their physiological implications . Adv Exp Med Biol 1978;103:381-394. 31. Ricour C, Millot M, Balsan S: Phosphorus depletion in children on long-term parenteral nutrition . Ada Paediatr Scand 1975;64:385-392.Crossref 32. Pettifor JM, Stein H, Herman A, et al: Mineral homeostasis in very-low-birth-weight infants fed own mother's milk or pooled pasteurized preterm milk . J Pediatr Gastroenterol Nutr 1986;5:248-253.Crossref 33. Kovar I, Mayne P, Barltrop D: Plasma alkaline phosphatase activity: A screening test for rickets in preterm infants . Lancet 1982;1: 308-310.Crossref 34. Bornstein P, Byers PH: Disorders of collagen metabolism , in Bondy PK, Rosenberg LE (eds): Metabolic Control and Disease . Philadelphia, WB Saunders Co, 1980, pp 1089-1153. 35. Fleischmajer R, Timpl R, Tuderman L, et al: Ultrastructural identification of extension amino-propeptides of type I and III collagens in human skin . Proc Natl Acad Sci USA 1981;78: 7360-7364.Crossref 36. Fleischmajer R, Olsen BR, Timpl R, et al: Collagen fibril formation during embryogenesis . Proc Natl Acad Sci USA 1983;80:3354-3358.Crossref 37. Carey DE, Goldberg B, Ratzan SK, et al: Serum immunoreactive procollagen levels in children with growth hormone deficiency and hypothyroidism , abstracted. Pediatr Res 1982;16: 135A. 38. Hyams JS, Carey DE, Leichtner AM, AM, et al: Type I procollagen as a biochemical marker of growth in children with inflammatory bowel disease . J Pediatr 1986;109:619-624.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: May 1, 1987

References