• Rickets developed in a very-low-birth-weight infant fed exclusively human milk. Serum 25-hydroxyvitamin D concentration was normal, and serum 1,25-dihydroxyvitamin D level was elevated; parathyroid hormone and calcitonin levels were normal. Rickets responded to supplements of calcium and phosphate, as determined by roentgenograms and measurement of bone mineral content by direct photon absorptiometry. Human-milk feeding in very-low-birth-weight infants requires observation for hypophosphatemia and clinical and radiological signs of rickets. In such infants, it may be necessary to supplement breast-milk feeding with calcium and phosphate.
(Am J Dis Child 1982;136:581-583)
Greer FR, Steichen JJ, Tsang RC. Calcium and Phosphate Supplements in Breast Milk–Related RicketsResults in a Very-Low-Birth-Weight Infant. Am J Dis Child. 1982;136(7):581–583. doi:10.1001/archpedi.1982.03970430013003
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