The case of an infant born prematurely who developed necrotizing enterocolitis and required parenteral nutrition for several months during a nationwide IV pediatric multivitamin shortage is presented. Metabolic bone disease commonly occurs in preterm infants receiving parenteral nutrition because of the failure to attain third-trimester, in utero, mineral accretion rates. The purpose of this case report is to review the relationships between vitamin D, calcium, and phosphorus for maintaining mineral homeostasis and bone development. Many questions remain to be answered regarding optimal mineral and vitamin D requirements of the preterm infant with suspected metabolic bone disease.
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