Early feeding, antenatal glucocorticoids, and human milk decrease intestinal permeability in preterm infants.
To determine the effects of age, feeding regimen, and antenatal glucocorticoids on intestinal permeability, preterm infants (n = 132) were stratified by gestational age and by diet (mothers' own milk versus preterm formula), and assigned randomly to one of four feeding regimens: early-continuous, early-bolus, standard-continuous, and standard-bolus. At 10, 28, and 50 d of age permeability was determined by measuring the ratio of lactulose/ mannitol in the urine after the two sugars were administered enterally for 30 h. The mean (+/-SE) birth weight and gestational age of the infants were 1044 +/- 13 g and 27 +/- 0.1 wk, respectively. Permeability changed as a function of age (p = 0.003). Early feeding was associated with a reduction in permeability at 10 d of age (p = 0.01). Antenatal steroid administration was associated with decreased permeability at 28 d of age (p = 0.017). The feeding of human milk (versus formula) was associated with decreased permeability at 28 d of age (p = 0.02). Continuous versus bolus feeding did not affect permeability.
Shulman
R J
RJ
USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, and Texas Children's Hospital, Houston 77030, USA.
Schanler
R J
RJ
Lau
C
C
Heitkemper
M
M
Ou
C N
CN
Smith
E O
EO
D000375:Aging; D000704:Analysis of Variance; D001724:Birth Weight; D004750:Enteral Nutrition; D005260:Female; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007225:Infant Food; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007408:Intestinal Absorption / Q000187:drug effects / Q000502:physiology; D007413:Intestinal Mucosa / Q000254:growth & development / Q000502:physiology*; D007421:Intestine, Small / Q000254:growth & development / Q000502:physiology*; D007792:Lactulose / Q000652:urine; D008353:Mannitol / Q000652:urine; D008895:Milk, Human; D010288:Parenteral Nutrition; D010539:Permeability; D011247:Pregnancy; D013997:Time Factors
D005938:Glucocorticoids; D008353:Mannitol; D007792:Lactulose