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
D. E. Carey, J. C. Rowe, C. A. Goetz, E. Horak, R. M. Clark and B. Goldberg
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.
