January 9, 2008, Updated September 19, 2012

A little bit of movement every day can help pre-term babies alleviate the symptoms of osteopenia.Today we all know that exercise is a vital component of any healthy lifestyle. And that’s no truer than for the youngest and most vulnerable of us all – the 12% of premature American babies born before the 37th week of pregnancy. Amongst many other challenges, these babies often suffer from brittle bones, having missed out on vital weeks of calcium deposition and bone strengthening in the womb. But now two Israeli doctors are pointing out something rather obvious – that these infants, like all of us, can benefit greatly from a bit of movement.

Dr Dan Nemet and Dr Alon Eliakim have been developing a program at Tel Aviv University’s Sacker School of Medicine which may revolutionize standard treatments for a condition known as osteopenia of prematurity, in which insufficiently formed bones become brittle and vulnerable to breakage. The pair, who work together in a pediatric health clinic specializing in childhood obesity and sports medicine, are currently coordinating large-scale trials of their treatment protocol – and expect that the method will make a big difference to a problem which is manifesting itself more and more in neonatal wards across the world.

“Most bone growth and strengthening happens during the last trimester of pregnancy,” explains Nemet. “Premature babies miss out though, so most of them have some degree of osteopenia.”

The condition – which is difficult to diagnose in infants who aren’t yet able to let Mom or Dad know that something is wrong – predisposes sufferers to hairline fractures, may delay muscle growth, and may also result in a lifelong vulnerability to osteoporosis. Traditional treatments involving calcium and phosphorus-based nutritional supplements have been shown to alleviate some symptoms, says Nemet, but never entirely. “We never reached 100 percent bone strength from this,” he told ISRAEL21c.

But the assisted exercise regime developed at TAU promises a stronger alternative. Recent trials involving brief 10 minute sessions of gentle flexion and extension motions on the wrist, elbow, shoulder, ankle, knee, and hip joints, performed five times a day, met with a heartening degree of success. “We’ve had encouraging results,” recalls Nemet. “The preemies are definitely gaining more bone mass, their bones are growing stronger and subsequently they are gaining more weight.”

Like established infant touch programs such as ‘kangaroo care’ – a regime of skin-to-skin contact between baby and caregiver originally developed as a way of dealing with equipment shortages in Colombian maternity wards – the exercise protocol can be taught to parents and carried out in the convenience of the home. But clinical studies have indicated that the benefits of such touch programs are far surpassed by the benefits of the TAU system. “We can assume it means that the preemies are healthier and happier,” says Nemet.

With such positive reports rolling in, the pair have now launched the program overseas, and are currently collaborating with a University of California-Irvine research group headed by Professor Dan Cooper. The joint Israeli-American team are conducting a double-blind study involving 100 babies, and expect to produce further results late next year detailing the impact of the regime on infant body composition, immune functions, and growth rate.

In the meantime, though, say the doctors, for parents and caregivers, it really just comes down to common sense. “If you think of a baby in the womb, it’s always moving, kicking, wiggling around. But premature babies get placed in incubators or cradles, and just lie there,” Nemet pointed out to ISRAEL21c.

And it might be assumed that the same wisdom applies to the world beyond the neonatal ward, he says, where full-term babies could also benefit from a bit of a workout with Mom and Dad. “We have such a widespread epidemic of childhood obesity right now, and there’s a belief that practices laid down in infancy can impact on lifelong health prospects.”

“We all know that exercise is good for adults,” says Nemet. “So why should infants be any different?”


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Jason Harris

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