In Reply.—We are particularly pleased that Drs Decsi and Fekete have submitted their data indicating that the adverse effect of decreased mineral intake on calcium homeostasis may be less dramatic in very-low-birth-weight infants with minimal illness than in those with medical complications of prematurity. Their data support the conclusions we drew from our own data. In our patients, not only did calcium homeostasis remain stable in the face of low mineral intake, as it did in Decsi and Fekete's study patients, but the increase in bone mineralization also followed the intrauterine rate. The patients in both studies received a lower mineral intake than the estimated requirement for an intrauterine rate of bone mineralization between 32 and 36 weeks' gestation.
These observations do not question the validity of the argument that decreased mineral intake is a major etiologic factor in the development of neonatal osteopenia. They do suggest, however, that although a