Can Phosphate Oral Solution Be Taken with Breast Milk or Formula?

Q: Can Phosphate Oral Solution Be Taken with Breast Milk or Formula?

Hello： According to the data, phosphate should not be taken with calcium-containing foods to avoid calcium-phosphate precipitation, which can affect absorption. <br>The last row of the table also serves as a reminder. <br>Wishing you health and happiness! <br>Neutral Phosphate Su

Can Phosphate Oral Solution be taken together with breast milk and formula milk?

Hello, my family has a 4-month-old premature baby.
The doctor prescribed vitamin D3 and phosphate oral solution to prevent fractures.
It was mentioned that vitamin D3 can be taken with breast milk and formula.
However, there is a concern regarding the phosphate solution.
The older generation in my family believes that phosphate solution should not be taken with breast milk or formula, as it would cause the milk to denature.
They insist that phosphate should be given 30 minutes before feeding, and only then can the baby be fed.
I have researched this online and consulted a pharmacist at a local hospital, but no one mentioned that phosphate cannot be taken with breast milk or formula.

I would like to ask the doctor if phosphate really needs to be given 30 minutes before feeding? Does taking it with breast milk truly cause the milk to denature? The older generation, despite being well-educated, insists on proof before they will believe me, and I am not quite sure what constitutes empirical evidence.
I feel that the idea of phosphate causing breast milk to denature is similar to the internet rumor that spinach and tofu should not be eaten together.

Since the baby needs to be fed every 2-3 hours, if phosphate is given 30 minutes before feeding, wouldn't that still lead to interaction with breast milk or formula? Honestly, I find it hard to believe that phosphate would denature breast milk.
If it were true that adding phosphate to breast milk would cause it to denature, would that have any effect on the baby? Would the denaturation of breast milk be similar to the denaturation of egg whites when cooked, or would it still be safe to consume?
I apologize for the detailed question, but I really want to understand whether phosphate and breast milk should not be taken together.
Thank you.

Johnson, 20~29 year old female. Ask Date: 2018/04/05

Dr. Pei Rensheng reply Pediatrics

Hello: According to the data, phosphate should not be taken with calcium-containing foods to avoid calcium-phosphate precipitation, which can affect absorption.
The last row of the table also serves as a reminder.
Wishing you health and happiness!
Neutral Phosphate Supply: Each packet of powder contains NaH2PO4·H2O 17.5g and Na2HPO4 28g; each packet contains 10g of elemental phosphorus (in 500mL distilled water: phosphorus 20 mg/mL) and sodium 38.23g (in 500mL distilled water: sodium 76.5 mg/mL).

Description: Neutral Phosphate is an agent for oral phosphate supplementation in the treatment of hypophosphatemia.

Pharmacokinetics: Bioavailability: ~1% to 20%.

Indication: Hypophosphatemic rickets, phosphate supplementation.

Dosage and Administration:
- Phosphate depletion: oral, 0.5 to 1 g of elemental phosphorus 2-3 times/day (25 to 50 mL bid to tid).

- Hypophosphatemic rickets: oral, 1 to 4 g of elemental phosphorus per day in divided doses.

Adverse Drug Reactions: Edema, hypotension; dizziness; headache; calcium phosphate precipitation; hypernatremia; hyperphosphatemia; hypocalcemia; abdominal bloating; abdominal pain; diarrhea; mucosal bleeding; nausea; superficial mucosal ulcerations; vomiting; acute renal failure.

Contraindications: Contraindicated in patients with acute colitis, acute phosphate nephropathy (biopsy proven), bowel obstruction, bowel perforation, congenital megacolon, gastric retention, hypomotility syndromes, ileus, pseudo-obstruction, severe chronic constipation, toxic megacolon, unstable angina.

Note:
1) Each packet of Neutral Phosphate should be dissolved in 500mL of warm water; then take according to the prescribed dosage and method.

2) 1 mmol of phosphate = 31 mg of phosphorus; 1 mg of phosphorus = 0.031 mmol of phosphate.

3) Please separate the use of antacids, calcium salts, iron salts, magnesium salts, sucralfate, and bisphosphonate derivatives to avoid reducing phosphate absorption.

Reply Date: 2018/04/05

More Info

When considering the use of Phosphate Oral Solution (phosphate) in conjunction with breast milk or formula for a premature infant, it is essential to understand both the nutritional implications and the biochemical interactions that may occur.
Phosphate is often prescribed to prevent conditions such as hypophosphatemia, which can lead to bone health issues, particularly in premature infants who may have increased nutritional needs. The concern raised by older generations about phosphate potentially causing breast milk or formula to "denature" is rooted in a misunderstanding of how these substances interact. Denaturation typically refers to the structural alteration of proteins, which can occur under certain conditions, such as heat or extreme pH changes. However, the addition of phosphate to breast milk or formula does not cause denaturation in the same way that cooking an egg does.

Research indicates that phosphate can be taken alongside breast milk or formula without significant adverse effects. However, it is generally advised to avoid combining phosphate with calcium-rich foods or supplements at the same time. This is because calcium and phosphate can form insoluble complexes, which may reduce the absorption of both minerals. Therefore, if phosphate is to be administered, it is often recommended to do so at least 30 minutes before feeding with breast milk or formula to optimize absorption and minimize any potential interaction.

The idea that phosphate could alter the nutritional quality of breast milk or formula is largely unfounded. Breast milk is a dynamic fluid that contains a variety of nutrients, including proteins, fats, carbohydrates, vitamins, and minerals, all of which are crucial for an infant's growth and development. The introduction of phosphate does not inherently change the nutritional profile of breast milk or formula; rather, it supplements the diet with an essential mineral that may be lacking.

In terms of practical advice, if your healthcare provider has prescribed phosphate for your infant, it is crucial to follow their guidance regarding timing and dosage. If there are concerns about the interaction between phosphate and breast milk or formula, it is advisable to consult with a pediatrician or a pediatric nutritionist. They can provide tailored recommendations based on your infant's specific health needs and nutritional requirements.

In conclusion, phosphate can be taken with breast milk or formula, but it is best to space the administration to avoid potential interactions with calcium. The notion that phosphate will denature breast milk or formula is a misconception. Instead, phosphate serves as a valuable supplement that can support the health and development of premature infants when used appropriately. Always consult with healthcare professionals for personalized advice and to ensure the best outcomes for your child's health.

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