The fortuitous discovery of bone mineralization abnormalities in premature babies fed a medium chain triglyceride supplemented formula and exhibiting satisfactory weight gains prompted us to perform calcium and phosphorus balance studies. The infants studied had no major neonatal disorders and were not vitamin D-deficient. Urine assays detected no phosphorus and demonstrated an increase in calcium excretion, suggesting an inadequate phosphorus intake. This hypothesis was confirmed by the appearance of urinary phosphates with a decrease in calcium losses following supplementation of the formula with phosphorus.

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