Is vitamin D supplementation necessary in healthy full-term breastfed infants? A follow-up study of bone mineralization in healthy full-term infants with and without supplemental vitamin D.

AIM: The aim of the study is to establish whether healthy full-term breastfed infants require supplemental vitamin D for proper bone mineralization. METHODS: Bone mineralization was studied by performing ultrasound scans of 73 healthy full-term subjects at the age of 3 months. The infants were divided into three groups. Group A: breastfed without supplemental vitamin D (BF); group B: breastfed with supplement of 400 IU/day of vitamin D (BFD); group C: fed with formula (with and without supplemental vitamin D 400 IU/day) (FF). The values of mcSOS (m/sec) and mcBTT (µsec) were assessed in all subjects. RESULTS: A statistically significant difference has been found between group A vs group B both in mcSOS (P=0.03) and in mcBTT (P=0.01) values and also between group A vs group C both in mcSOS (P=0.012) and in mcBTT (P=0.003) values. Significant differences between group B vs group C were not found. In 75% of subjects of group A mcSOS and mcBTT values were ≤ the 10th percentile, while in group B they were between the 10th and 50th percentile. In FF infants given supplemental vitamin D mcSOS and mcBTT values were between the 25th and 75th percentile. CONCLUSION: Human breast milk is an appropriate source of nutrition for the growth of healthy full-term newborns, but is poor in vitamin D as demonstrated by the impaired bone mineralization in the breastfed infants without supplemental vitamin D. The results presented demonstrate that exclusively breastfed infants require at least 400 IU/day of supplemental vitamin D.

[Extrauterine adaptation: cardiac output changes in different modes of delivery. Preliminary results]. / Adattamento extrauterino: variazioni dell'output cardiaco in diverse modalità di parto: risultati preliminari.

Cardiac output in two homogeneous populations of term newborns, by spontaneous delivery and cesarean section without labour, has been estimated at 2, 24, 48, 72 and 96 hours after birth. Changes has been noticed in Cardiac Output in the first day of life and between different mode of delivery. Larger charges has been noticed in spontaneous then in cesarean delivery.

Aspartate aminotransferase and alanine aminotransferase serum activities in neonatal transient myocardial ischemia.

The behavior of serum aspartate aminotransferase and alanine aminotransferase was evaluated during the first 30 postnatal days in 16 neonates with clinical, electrocardiographic and echocardiographic features of transient myocardial ischemia. These common laboratory tests, requested usually as an aid to diagnosis and surveillance of myocardial damage both in the adult and infant age groups, do not seem to have any value in the perinatal period compared to established reference values of healthy or asphyxiated controls.

Calcium homeostasis in the first days of life in relation to feeding.

Determinations of serum calcium (Ca), phosphorus (P), magnesium (Mg), calcitonin (CT) and parathyroid hormone (PTH) were carried out in full term newborn infants during the first 168 h of life. The infants were randomly assigned to two different diets: glucose and breast feeding (BF) only or early formula feeding (F). The Ca serum levels decreased from birth to the 24th h; after that time they increased until the 72nd h. The values of serum Ca at the 48th and 72nd h were significantly lower in the F than in the BF group. In contrast, the P serum levels increased from birth to the 48th h and then they decreased; the values of serum P at the 48th h were significantly higher in F than in the BF group. The CT serum levels increased from birth to the 24th h and then they decreased. No difference between the F and BF groups was found during the first 48 h, while at the 72nd h the F group demonstrated significantly higher values of serum CT. PTH serum levels also increased from birth to the 24th h with significantly higher values at the 72nd h in the F group. The results of this investigation demonstrate that the difference in feeding in the first hours of life affects the calcium homeostasis and the secretion of hormones involved in the regulation of serum Ca levels.

Calcitonin and parathyroid hormone in newborn infants with fracture of the clavicle.

Determinations of serum calcium (Ca), phosphorus (P), calcitonin (CT), and parathyroid hormone (PTH) were carried out in 36 full-term newborn infants with fracture of the clavicle (CF) and in 46 normal neonates (N). At the 6th hour of life the CF neonates demonstrated lower serum Ca and higher serum CT in comparison with normal infants. In the hours following, no significant differences between the two groups for the Ca levels were found, whereas serum CT remained significantly higher in the CF newborns at the 24th, 48th, and 72nd hour of life. Significant differences between normal and CF infants in the PTH serum levels were detected only at the 48th hour, when PTH was lower in the CF newborns. The results of this investigation indicate that the fracture of the clavicle is a significant and peculiar factor in stimulating CT secretion. Serum Ca level appeared to be controlled by CT rather than auto-regulating the secretion of the hormone.

[Serum levels of parathormone, calcium, magnesium and phosphorus in the perinatal period]. / Livelli serici di paratormone, calcio, magnesio e fosforo nel periodo perinatale.

Two groups of newborns on different diets were studied: group A was given artificial milk, while group B was breast fed. Blood samples from the cord artery and vein were taken at birth and further blood samples after 1, 6, 12, 24, 48, 72, 96 and 168 hours. No baby underwent more than three blood samples. Calcium (Ca), magnesium (Mg), phosphorus (P) and parathormone (PTH) were measured in all samples. There was a rapid increase in PTH levels in all subjects in the first hours after birth. At 48th the babies in group A had significantly higher serum levels of P than the group B subjects, and their serum Ca and Mg levels were significantly lower. At 72th PTH serum levels were significantly higher in group A, while Ca and Mg levels were significantly higher in group B. In conclusion, the subjects demonstrated a normal secretion of PTH at birth, and the type of diet notably influenced the homeostasis of calcium in the perinatal period.

[The secretion of calcitonin in the newborn infant in relation to the method of delivery]. / La secrezione di calcitonina nel neonato in relazione alle modalita' del parto.

Determinations of serum (Ca) and calcitonin (CT) were carried out in 80 full term newborn infants. 40 of them were born by elective Caesarean section (ECS) while 40 were born by normal vaginal delivery (VD). Samples of blood were drawn at 1, 24, 48, 168 hours of life. Each newborn was tested no more than twice. Serum Ca of ECS at 24th hour was significantly less than Ca of VD. At the same time CT of ECS was significantly higher than CT of VD. A negative significant correlation between Ca and CT was observed. The data demonstrate the key role of CT in the homeostasis of Ca in the first hours of life. In addition, the results were suggestive for a dependence of CT secretion on the stress of birth.

[Serum calcitonin in full-term infants]. / Calcitonina serica nel neonato a termine.

Determination of calcium (Ca) calcitonin (CT) secretion in mother during labour and their newborns during the first hours of life was carried out. Mean serum levels of Ca decreased after the birth. Mean serum level of Ct was higher in the cord blood comparing with mothers blood. These levels increased after the 6th hour and reached the peak at the 12nd hour. After the 24th hour the CT levels decreased significantly although at the 48th hour they remained higher than those in the cord blood.