Bone mass in First Nations, Asian and white newborn infants.

OBJECTIVE: To compare bone mass in newborn infants of First Nations, white and Asian mothers while accounting for vitamin D status. Fifty infants born healthy at term age were measured for bone mass using dual energy x-ray absorptiometry (DXA) within 15 days of life. Vitamin D status was measured as 25(OH)D in cord plasma. White infants were separated based on 25(OH)D concentrations into sufficient and insufficient (< 32.5 nmol/L) to match for vitamin D status of the Asian infants and the First Nations group. Differences among groups were tested using ANOVA and post hoc testing with Bonferroni multiple comparisons test. There were no differences in whole body, spine or femur BMC between the white sufficient and insufficient infants. However, the Asian infants had lower (P < 0.01) spine BMC compared to the white infants and the First Nations infants were intermediate. No differences among the ethnic groups were observed for whole body or femur BMC. These data suggest that white and First Nations newborn infants have comparable bone mass. Asian infants have lower spine bone mass which is more than a factor of body size and independent of vitamin D status at birth.

Minimal enteral feeding within 3 d of birth in prematurely born infants with birth weight < or = 1200 g improves bone mass by term age.

BACKGROUND: Evidence-based practice guidelines for aggressive nutritional intervention by using parenteral amino acids (AAs) and minimal enteral feeding (MEF) as early as the first day of life have not been tested for benefits to bone mass. OBJECTIVE: We investigated whether early introduction of parenteral AAs and MEF improves growth and bone mass achieved by term age in infants born prematurely. DESIGN: Twenty-seven infants who were < or = 1200 g and < or = 32 wk gestation at birth were randomly assigned by using a 2 x 2 design to treatment of either 1 g AAs/kg within the first 24 h or 12 mL MEF x kg(-1) x d(-1) within the first 72 h of life. Nutrition and growth were documented during hospitalization, and bone mineral content (BMC) of lumbar spine 1-4, femur, and whole body was measured at term age. Biomarkers of bone metabolism were measured at weeks 1, 3, and 5 and at discharge. Statistical analysis was conducted by using 2 x 2 analysis of variance for intent to treat and for infants receiving protocol nutrition. RESULTS: Over the first 14 d of life, a main effect of early AAs elevated total intake of protein, and a main effect of early MEF was a higher frequency of MEF volumes exceeding > 12 mL x kg(-1) x d(-1). Main effects on growth were not evident. An interaction effect was observed for osteocalcin whereby early AAs or MEF alone elevated osteocalcin. A main effect of early MEF yielded higher BMC of spine and femur. CONCLUSION: Early aggressive nutrition support with MEF enhances BMC in premature infants, but early MEF or AAs do not improve growth.