Calcium and phosphorus supplementation of human milk for preterm infants

Publisher Website
Google Scholar
Abstract
Preterm infants are born with low skeletal stores of calcium and phosphorus. Preterm human milk provides insufficient calcium and phosphorus to meet their estimated needs. To determine if addition of calcium and phosphorus supplements to human milk leads to improved growth and bone metabolism without significant adverse effects in preterm infants. The standard search strategy of the Cochrane Neonatal Review Group (NRG) was used. This includes searches of the Oxford Database of Perinatal Trials, MEDLINE, previous reviews including cross references, abstracts, conferences and symposia proceedings, expert informants, journal handsearching mainly in the English language. All trials utilizing random or quasi-random allocation to supplementation of human milk with calcium and/or phosphorus or no supplementation in preterm infants within a hospital were eligible. Data were extracted using the standard methods of the Cochrane NRG, with separate evaluation of trial quality and data extraction by each author and synthesis of data using relative risk and weighted mean difference. No studies which met selection criteria were identified. Excluded studies that were identified included minerals as one component of a multicomponent fortifier or reported only non-clinical outcomes (for example, urinary excretion of calcium). Two studies were excluded because of methodological concerns. There are no randomized controlled data evaluating clinical outcomes of calcium and phosphorus supplementation of human milk for preterm infants on which to base practice recommendations. Further trials should assess the clinical benefits and potential adverse effects of supplementation of human milk with minerals. This may best be done in the context of manipulation of the composition of human milk fortifiers containing multiple nutrients (carbohydrate, protein, and minerals). 以補充鈣和磷的母乳喂養早產兒 早產兒出生時骨骼中儲存的鈣和磷的量較低。早產的母乳不能提供足量的鈣和磷以滿足早產兒的需要。 為確定在母乳中增加補充鈣和磷是否改善新生兒的生長及骨代謝而無不良影響。 應用Cochrane新生兒評價組(NRG)的標準策略進行檢索。這包括檢索牛津週產期臨床試驗資料庫試驗數據庫、MEDLINE、包括參考文獻在內以往的評價/綜述、摘要、學術會議和研討會論文集，專家信息，對主要是英語的雜誌進行手工檢索。 所有對在醫院中母乳喂養早產兒使用隨機或半隨機分配法予補充鈣和/或磷或不補充的試驗均符合要求。 應用Cochrane新生兒評價組的標準方法提取數據，由每位作者分別評估試驗質量和提取數據，應用相對危險度和加權均數差對數據進行綜合。 未查到符合選擇標準的研究。以礦物質作為多成分強化劑的一種成分或僅報告非臨床結局(例如尿的鈣排泄)的研究不予納入。有兩項研究因方法學問題未予納入。 沒有評估補充鈣和磷的母乳喂養早產兒的臨床結局的隨機對照數據，而這些數據是實踐建議的基礎。應通過進一步的試驗，對在母乳中補充礦物質的臨床好處及可能不良影響進行評估。這種研究最好是在控制含多種營養素(碳水化合物、蛋白質和礦物質)的母乳強化劑成分的條件下進行。 本摘要由臺中榮民總醫院薛榮華翻譯。 此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。 額外添加鈣，磷到母乳來增加早產兒成長。早產兒出生時其骨骼是較少的鈣和磷儲存，因為三分之二的礦物質含量是在第三孕期吸收的。因為礦物質對於強健骨骼是重要的，所以低鈣磷使他們處於骨折的風險和低於預期的成長速度。這導致了普遍會補充礦物質到母乳和早產兒配方奶。嬰兒可以大量飲用來獲得足夠的蛋白質和鈉。但若過度補充鈣磷可能會產生不利影響，包括鈣累積(包括在腎臟內)和餵養不耐受。本回顧作者檢索了相關對照控制試驗的醫學文獻，有關早產兒在醫院環境下，補充鈣，磷到母乳並測量其生長和骨骼代謝。沒有研究是母乳只加上鈣，磷，通常都會添加多種營養素包括碳水化合物，蛋白質和礦物質。

This publication has 13 references indexed in Scilit: