Thermoregulatory control of feeding and sleep in premature infants.
OBJECTIVE
The aim of the present study was to test the thermoregulatory feeding control hypothesis in sleeping, premature infants.


METHODS
In premature infants, the energy supply from food intake is crucial for (in order of importance): organ operation, body homeothermia, and optimal growth. The Himms-Hagen model of thermoregulatory feeding control involving activation of heat production by brown adipose tissue (BAT) was formulated on the basis of work in (awake) rats. This hypothesis has also been put forward for the human neonate, which can also use BAT to produce metabolic heat. According to the model, feeding episodes occur during a transient increase in body temperature. Feeding is initiated by a dip in blood glucose concentration after sugar uptake by activated BAT.


RESULTS
In 14 neonates (bottle-fed on demand), food intake always took place during an increase in skin temperature (+0.19 +/- 0.21 degrees C). Awakening occurred 18 +/- 17 minutes after the minimum skin temperature level had been reached. When feeding time was imposed, feeding was not necessarily situated during an increase in skin temperature, and the sleep duration after food intake increased significantly (+43%). This could be considered as an adaptive response to the short-term sleep deprivation and/or stress elicited by an imposed feeding rhythm.


CONCLUSIONS
The validity of the model supports the use of on-demand feeding in neonatal care units, in accordance with the infant's physiological body temperature oscillations.
Chardon
Karen
K
Dysrégulations Métaboliques Acquises et Génétiques Equipe d'accueil 3901-Institut National de l'Environnement Industriel et des Risques, Faculty of Medicine, University of Picardy Jules Verne, Amiens, France.
Cardot
Virginie
V
Léké
André
A
Delanaud
Stéphane
S
Bach
Véronique
V
Dewasmes
Gérard
G
Telliez
Frédéric
F
D002001:Adipose Tissue, Brown / Q000378:metabolism; D000704:Analysis of Variance; D001833:Body Temperature Regulation / Q000502:physiology*; D004435:Eating / Q000502:physiology*; D004734:Energy Metabolism / Q000502:physiology*; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development / Q000378:metabolism / Q000502:physiology; D012890:Sleep / Q000502:physiology*