Randomized controlled study of digestive enzyme activity following trophic feeding.
A randomized, controlled, prospective study of 80 preterm infants of birthweight less than 1750 g requiring ventilatory support was performed. While ventilatory support was required group TF (39 infants) received trophic feeding (0.5-1 ml h(-1)) along with parenteral nutrition, whereas group C (41 infants) received parenteral nutrition alone. When ventilatory support was no longer required milk feeds were started in group C and then increased in both groups until full milk feeds were established. The ratio of lactase to sucrase activity (L:S ratio) was measured in aspirated proximal intestinal fluid on 3 occasions: immediately after ventilatory support was withdrawn (T0), 7 days later (T7) and 14 days later (T14). On the same 3 occasions faecal chymotrypsin activity was measured. The mean difference (95% confidence interval) L:S ratio was significantly higher in group TF at both T0 and T14, 1.8 (0.03, 3.57) and 0.78 (0.2, 1.35) U l(-1), respectively. There was no significant difference in faecal chymotrypsin concentration.


CONCLUSIONS
Trophic feeding alters relative intestinal disaccharidase activity, probably by inducing lactase production, but has no effect on pancreatic chymotrypsin activity.
McClure
R J
RJ
Regional Neonatal Intensive Care Unit, St James's University Hospital, Leeds, UK. rob.mcclure@addenbrookes.nhs.uk
Newell
S J
SJ
D002918:Chymotrypsin / Q000032:analysis / Q000378:metabolism*; D016001:Confidence Intervals; D004064:Digestive System / Q000201:enzymology*; D004750:Enteral Nutrition / Q000379:methods*; D005243:Feces / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D043322:Lactase; D008297:Male; D010179:Pancreas / Q000201:enzymology*; D010288:Parenteral Nutrition / Q000379:methods*; D011336:Probability; D011446:Prospective Studies; D012121:Respiration, Artificial; D018709:Statistics, Nonparametric; D013393:Sucrase / Q000032:analysis / Q000378:metabolism; D001616:beta-Galactosidase / Q000032:analysis / Q000378:metabolism
D043322:Lactase; D001616:beta-Galactosidase; D013393:Sucrase; D002918:Chymotrypsin