Doctors need better tools to check if newborns and babies have healthy bones, especially those at risk for weak bones. This review looks at different methods doctors use today—from blood tests to special scanning machines—and introduces a newer technology called REMS that doesn’t use radiation and is easier to use. The challenge is that doctors don’t yet have clear guidelines for diagnosing bone problems in babies or standard measurements to compare results. Researchers say we need more studies to create better standards and help doctors catch bone health issues early in infants.

The Quick Take

  • What they studied: Different methods doctors use to measure bone strength and health in newborns and babies, and how well these methods work
  • Who participated: This is a review article that examined existing research and technologies rather than studying a specific group of babies. It focused on babies at risk for weak bones, including premature babies, babies with low birth weight, and babies whose mothers had vitamin D deficiency
  • Key finding: A newer technology called REMS appears to be better than older methods for checking baby bone health because it doesn’t use radiation, is easy to use, costs less, and gives reliable results
  • What it means for you: If you have a newborn or baby at risk for bone problems, doctors may soon have better tools to check their bone health. However, doctors still need to do more research to create standard measurements that work for all babies before this technology becomes widely used

The Research Details

This is a narrative review, which means researchers looked at and summarized existing studies and information about bone health testing in babies rather than conducting their own experiment. They examined what doctors currently use to check baby bones—including blood tests that measure bone-related chemicals, X-ray machines that measure bone density, and ultrasound technology. The review focused on the strengths and weaknesses of each method and introduced REMS (Radiofrequency Echographic Multi-Spectrometry), a newer technology that uses sound waves instead of radiation to measure bone health.

The researchers identified babies at higher risk for weak bones, such as those born too early, those weighing less at birth, and babies whose mothers didn’t have enough vitamin D during pregnancy. They explained why having good tools to check these babies’ bones early is important for their long-term health.

Checking bone health in babies is tricky because babies are growing so fast and their bones are still developing. Current methods have problems—some use radiation (which doctors want to avoid in babies), some are hard to use, and some give inconsistent results. Having better, safer, and easier methods could help doctors spot bone problems early and help more babies stay healthy

This is a review of existing research rather than a new study, so it summarizes what scientists already know. The authors looked at multiple technologies and methods, which gives a broad picture. However, because this is a review and not original research with babies, the findings depend on the quality of studies they reviewed. The authors clearly state that more research is needed to validate the newer REMS technology in babies

What the Results Show

Current methods for checking baby bone health have significant limitations. Blood and urine tests can show some information about bone health, but they don’t give a complete picture. Older scanning technologies like DXA (a type of X-ray) and QUS (ultrasound) can measure bone density, but they have problems—DXA uses radiation that doctors prefer to avoid in babies, and both methods have difficulty getting accurate measurements in very young children.

REM technology appears to be a major improvement. It uses sound waves instead of radiation, making it safe to use repeatedly on babies and pregnant women. It’s also easier to use than other methods, costs less money, and gives consistent, reliable results. Because it’s safe and easy, doctors could potentially screen many more babies for bone problems.

However, there’s an important gap: doctors don’t yet have standard reference values for REMS in babies. This means they can’t easily compare one baby’s results to what’s normal for their age, which makes diagnosis difficult. The researchers emphasize that this is the biggest barrier to using REMS widely in babies right now.

The review identifies several risk factors that make some babies more likely to have weak bones, including mothers with low vitamin D during pregnancy, premature birth, low birth weight, and certain pregnancy complications. Understanding these risk factors is important because it helps doctors know which babies should be screened. The review also notes that biochemical markers (blood and urine tests) can be useful when combined with imaging technology, suggesting that the best approach might use multiple methods together rather than relying on just one test

This research builds on decades of work trying to measure bone health in babies. Previous studies established that DXA and QUS could measure bone density, but doctors have been looking for better alternatives because of radiation concerns and accuracy problems. REMS is relatively new technology that appears to address many of the problems with older methods. The review suggests REMS represents a significant step forward, though it notes that the technology still needs validation in babies before it becomes standard practice

This is a review article, not a study of actual babies, so it doesn’t provide new experimental data. The authors couldn’t compare REMS directly to other methods in babies because validated reference standards don’t exist yet. The review is limited by the quality and quantity of existing research on REMS in infants—there simply isn’t enough published data yet. Additionally, the review doesn’t address cost-effectiveness or how easily REMS technology could be made available in different healthcare settings around the world

The Bottom Line

Based on current evidence, REMS technology shows promise for checking bone health in newborns and babies, particularly those at higher risk for weak bones (moderate confidence level). However, doctors should not yet rely on REMS as the sole method for diagnosing bone problems in babies because standard reference values haven’t been established. For now, combining REMS with blood tests and clinical evaluation appears to be the most reasonable approach (moderate confidence). Parents of babies at risk should discuss bone health screening with their pediatrician

Parents and doctors caring for babies at higher risk for weak bones should pay attention to this research, including those with premature babies, low birth weight babies, or babies whose mothers had vitamin D deficiency. Pediatricians and neonatologists (doctors who care for newborns) should be aware of REMS as an emerging tool. Healthy full-term babies without risk factors typically don’t need bone health screening. Pregnant women with vitamin D deficiency should also care about this research since maternal health affects baby bone development

If REMS technology becomes widely available and validated, doctors could potentially screen babies for bone problems within the first weeks or months of life. However, seeing actual improvements in baby bone health would take longer—months to years—depending on treatment. The research suggests that establishing standard reference values and guidelines could take 2-5 years of additional studies

Want to Apply This Research?

  • Track your baby’s risk factors for weak bones: maternal vitamin D levels during pregnancy, birth weight, gestational age at birth, and any bone health screening tests performed. Record dates and results of any REMS scans or bone density measurements
  • If your baby is at risk for weak bones, use the app to remind you to: ensure adequate vitamin D intake (through diet, supplements, or safe sun exposure), maintain calcium-rich nutrition, and keep all pediatric appointments for bone health monitoring. Set reminders for vitamin D supplementation if recommended by your doctor
  • Create a long-term tracking system that records all bone health assessments over time, including dates of REMS scans, blood test results for bone markers, and growth measurements. This helps you and your doctor monitor trends and catch any problems early. Share this data with your pediatrician at each visit

This review discusses emerging medical technology and research about baby bone health. It is not a substitute for professional medical advice, diagnosis, or treatment. If you have concerns about your baby’s bone health, especially if your baby was born prematurely, had low birth weight, or if you had vitamin D deficiency during pregnancy, please consult with your pediatrician or a pediatric bone specialist. Do not make any changes to your baby’s care or nutrition based solely on this information. REMS technology is still being validated in infants and may not be available at all medical facilities. Always work with your healthcare provider to determine the best approach for your individual baby’s health needs.