Osteopenia of prematurity

Osteopenia of prematurity is a condition where there is a decreased amount of essential minerals, calcium and phosphorus, in the bones. This makes the bones brittle and more susceptible to fractures and breaks. As a condition that largely affects premature infants, the incidence rate is correlated with both birth weight and degree of prematurity. It is common among infants born younger than 28 weeks, and occurs in about half of infants born weighing less than 1000g.

Symptoms of osteopenia

Even though this condition is common among premature infants, these infants may not show any physical symptoms. Those with severe osteopenia may show decreased mobility or have a swollen arm or leg because of an undetected fracture.

Causes of osteopenia

Osteopenia greatly affects premature infants because they were not able to get as much calcium and phosphorus from the mother in the womb. This transfer of minerals happens the most in the last 3 months of pregnancy. During this time, infants are also the most active. Physical activity promotes bone development. Infants born premature, however, are often a lot less active. They also lose more phosphorus through their urine.

Preemies with other conditions that affect nutritional intake and mineral absorption, such as bronchopulmonary dysplasia and short bowel syndrome, can also develop osteopenia. A lack of vitamin D does not allow the body to effectively absorb calcium and phosphorus.

Other factors that affect the infant’s predisposition to osteopenia include placental problems experienced by the mother during pregnancy, as well as her lifestyle.

Risks of osteopenia

Infants with severe osteopenia are very fragile as they are highly susceptible to fractures. These fractures, however, will heal well with proper care and dietary intake of supplemental calcium and phosphorus.

Dealing with osteopenia

In the NICU, infants with osteopenia will be given calcium and phosphorus supplements that are either added to breast milk, formula or IV fluids. In premature infants with very low birth weight, administration of supplements via IV fluids is more common as they may not be able to tolerate regular feeds yet. Vitamin D supplements may also be given to infants who have liver problems.

When your child is discharged from the NICU, you may need to continue giving them the calcium and phosphorus supplements.

Medical homecare equipment explained:

  • Infusion Pump

An infusion pump is a device that administers controlled dosages of fluids and or medication. The flow rate can be adjusted as required. This pump can be connected to an IV tube that has been placed in vein in the hand, foot or scalp of the baby. It can also be connected to a peripherally-inserted central catheter (PICC) line that is usually inserted near the elbow. This pump enables parents to continue TPN at home.