A Narrative Review of Calcium, Phosphate, Magnesium and Vitamin D Metabolism in Breastfed Preterm Babies

Abstract

Calcium, magnesium, phosphate and Vitamin D metabolism is intricately interwoven in human beings. For the foetus, the accretion of these nutrients occurs mainly in the third trimester. Hence, babies who are delivered preterm are at risk of suffering a deficiency of these micronutrients. Inadequate micronutrients can impair the infants' cellular functions, growth and development. Hence, this paper reviews the determinants of plasma levels of the micronutrients and how they are mobilised. It also reviews the evidence about the quantities of the nutrients available in breast milk and how much of them are available to the infant at optimal breastfeeding volumes. The possible implications on growth and the argument for or against supplementation of the nutrients in pregnant women and their preterm neonates who are exclusively breastfed are also discussed.