Metabolic bone disease in preterm infants
The original publication is available at http://www.samj.org.za
Small preterm infants often develop osteopenia with or without rickets and with or without fractures. Whether these bone abnormalities all form part of the same disease process with a wide spectrum of presentation or whether each abnormality represents a different disease is as yet unclear. Bone mineralization depends largely on adequate supplies of calcium and phosphate. The normal intra-uterine accretion of these minerals is higher than can be achieved by feeding preterm babies postnatally with breastmilk or conventional formulas. Supplementation with calcium, phosphorus and vitamin D is needed to prevent the development of 'neonatal osteopathy'. The main action of vitamin D in the preterm baby is probably to increase the intestinal absorption of calcium and phosphorus, although it may, together with other calciotrophic hormones, have a more specific effect on bone growth.
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