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Metabolic bone disease is a frequent condition in very low birth weight (VLBW) infants In order to prevent the disease, the provision of high amount of calcium and phosphate in parenteral nutrition solutions and during transition to the full enteral feedings is crucial. Current practice supports early aggressive mineral supplementation. In this review, we will discuss data from the recent literature regarding the recommendation for supplementation of calcium, phosphate and vitamin D in VLBW infants and the interpretation of indirect markers of bone metabolism for screening, diagnosis and monitoring high risk infants, as well as to guide treatment.
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