Patent ductus venosus does not lead to alimentary galactosaemia in preterm infants.
The aim of this study was to investigate if an open ductus venosus representing a portal-caval shunt can lead to transient "alimentary galactosaemia" in preterm infants fed human breast milk. Twenty-six preterm infants (28-34 wk of gestational age) with open ductus venosus were included. Capillary blood samples for measurement of galactose and glucose were collected before, 30 and 50 min after a meal with breast milk (range 12-23 mL/kg). Ultrasound studies of the blood flow in the ductus venosus, truncus coeliacus, superior mesenteric artery and left hepatic vein were performed before and 30 min after the meal. There was a significant rise in blood glucose after 30 and 50 min, indicating a sufficient lactose load. Galactose, however, was either not detectable or was just above the detectable limit (0.1-0.4 mmol/L), with no changes after the meal. An increased flow velocity was found in the ductus venosus and superior mesenteric artery after 30 min (p < or = 0.001) indicating increased entero-hepatic and portal-caval shunting.


CONCLUSIONS
A patent ductus venosus does not lead to a significant hypergalactosaemia in preterm infants fed human breast milk. Thus, in respect to breast-milk feeding, this is regarded safe in healthy preterm infants even with an open ductus venosus. The increased portal-caval shunting may, however, influence the hepatic metabolism of other enterally absorbed substances.
Department of Paediatrics , Ullevål University Hospital, Oslo, Norway. drude.fugelseth@ulleval.no
D
D
Fugelseth
C
C
Guthenberg
L
L
Hagenfeldt
K
K
Liestøl
M
M
Hallerud
R
R
Lindemann
D001724:Birth Weight; D001783:Blood Flow Velocity / Q000502:physiology; D001786:Blood Glucose / Q000378:metabolism; D005693:Galactosemias / Q000175:diagnosis*; D005865:Gestational Age; D006503:Hepatic Veins / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D011168:Portal System / Q000002:abnormalities* / Q000601:surgery; D011169:Portal Vein / Q000002:abnormalities* / Q000601:surgery; D011170:Portasystemic Shunt, Surgical; D014471:Umbilical Veins / Q000002:abnormalities* / Q000601:surgery
D001786:Blood Glucose