Greer F R, Steichen J J, Tsang R C
Am J Dis Child. 1982 Jul;136(7):581-3. doi: 10.1001/archpedi.1982.03970430013003.
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.
一名极低出生体重儿纯母乳喂养后发生了佝偻病。血清25-羟维生素D浓度正常，血清1,25-二羟维生素D水平升高；甲状旁腺激素和降钙素水平正常。通过X线片及直接光子吸收法测定骨矿物质含量发现，补充钙和磷后佝偻病症状有所改善。极低出生体重儿进行母乳喂养时，需要观察有无低磷血症以及佝偻病的临床和放射学表现。对于此类婴儿，可能有必要在母乳喂养的基础上补充钙和磷。
