Importance Of Calcium & Phosphorus Supplementation For Premature BabiesDr. Hiren Nalin Doshi
Director, PICU and NICU
Nanavati Max Super Speciality Hospital, Mumbai
MBBS, DCH, DNB(Pediatrics)
The last few weeks of growth in the womb are critical for many reasons. So, when a baby is born prematurely, their early departure from the mother’s womb keeps them from absorbing adequate minerals for their optimal growth and development.
Having lower than required levels of minerals like calcium and phosphorus can make an infant’s bones weak and cause life-long issues. The good news is that mineral supplementation for premature babies can help lower this risk. Here’s what you need to know.
Why are calcium and phosphorus needed?
Calcium and phosphorus are essential minerals needed for healthy bones and normal growth & development. These minerals are the key components of a bone mineral known as hydroxyapatite. This is what makes bones dense and keeps them from fracturing easily. These minerals are also required for healthy teeth and a child’s overall physiological development.
Calcium and phosphorus levels in preterm babies:-
During the last trimester of pregnancy, a baby absorbs large amounts of calcium and phosphorus from the mother. In the case of a full-term baby, strengthening of the bones begins in-utero and continues as the baby grows. As a result of being born prematurely, your baby may be unable to absorb the required amount of these minerals.
It is also important to note that apart from having low levels of calcium and phosphorus, premature infants also tend to lose more phosphorus in their urine as compared to full-term babies.
What is the risk of low calcium and phosphorus levels?
Inadequate mineral presence can lead to issues like osteopenia in infants. As the body grows, old bone tissues are constantly reabsorbed and replaced by new bone tissue. Issues like osteopenia can slow the rate at which new bone tissue is generated. This lowers bone density and thus makes the bones weaker and brittle.
Babies with this condition can find themselves at a higher risk for fractures and other issues like rickets. At a later age, this could also affect posture and limit the height.
Breastmilk as a source of calcium and phosphorus:-
Human milk is the best source of nutrition for infants during the first 6 months of postnatal life. It has the perfect balance of nutrients and provides additional immunoglobulins, hormones and other substances that offer a physiological advantage. The body does not produce calcium on its own and thus babies are dependent on their feed for these minerals. In the case of a full-term baby, breastmilk has sufficient nutrients to maintain healthy mineral levels.
In the case of a premature baby, breastmilk alone may not be enough. There are two aspects to this issue. Firstly, when a baby is born prematurely the mother may not be able to produce sufficient breastmilk. So, the baby’s overall nutritional needs may not be met. Secondly, the milk that is produced has lower than the required amount of these minerals. Studies have found that preterm infants fed solely on breastmilk may develop hypophosphatemia and show signs of poor bone mineralization in which case, you may need to add supplements to your baby’s feed.
Thankfully, rather than turning to cow’s milk-based products such as infant formula or fortifiers, mothers of preterm infants can use donor milk which is pasteurised human milk donated by donor mothers who produce more breastmilk than what is required by their babies. This can be further supplemented with human milk-based fortifiers which ensure babies receive the optimal amounts of Calcium & Phosphorus, in addition to receiving a 100% human milk diet which is clinically proven to have improved outcomes for premature babies.
Supplementation for premature babies:-
Given the need for high amounts of calcium and phosphorus and the limited availability of breastmilk, premature babies need supplemental feeding. Studies have found that using organic calcium and phosphate salts in the form of supplements is more effective.
The exact amounts required vary depending on the baby’s weight and the rate of weight gain. Needless to say, it needs to be individually adjusted. You need to work closely with your doctor to ensure that your baby gets the right balance of nutrients, especially Calcium & Phosphorus which are associated with bone health.
It is natural to worry about your premature baby but with just a little extra care and attention, your baby will grow up to be the happy, healthy bundle of joy you have always dreamt of.