title: The effect of enteral supplementation of a prebiotic mixture of non-human milk galacto-, fructo- and acidic oligosaccharides on intestinal permeability in preterm infants.
abstract: Preterm infants have an impaired gut barrier function. We aimed to determine the effects of enteral supplementation of a prebiotic mixture consisting of neutral oligosaccharides (short-chain galacto-oligosaccharides (SCGOS)/long-chain fructo-oligosaccharides (LCFOS)) and acidic oligosaccharides (AOS) on intestinal permeability of preterm infants as measured by the sugar absorption test in the first week of life. Furthermore, we determined host- and treatment-related factors associated with intestinal permeability. In a randomised controlled trial, preterm infants with a gestational age < 32 weeks and/or birth weight (BW) < 1500 g received enteral supplementation of SCGOS/LCFOS/AOS or placebo (maltodextrin) between days 3 and 30 of life. Intestinal permeability, reflected by the urinary lactulose/mannitol (L/M) ratio after oral ingestion of lactulose and mannitol, was assessed at three time points: before the start of the study (t = 0), at day 4 (t = 1) and at day 7 (t = 2) of life. Data were analysed by generalised estimating equations. In total, 113 infants were included. Baseline patient and nutritional characteristics were not different between the SCGOS/LCFOS/AOS (n 55) and the placebo groups (n 58). SCGOS/LCFOS/AOS had no effect on the L/M ratio between t = 0 and t = 2. In both the groups, the L/M ratio decreased from t = 0 to t = 2 (P < 0·001). Low BW increased the L/M ratio (P = 0·002). Exclusive breast milk feeding and mixed breast milk/formula feeding during the first week of life decreased the L/M ratio (P < 0·001 and P < 0·05, respectively). In conclusion, enteral supplementation of a prebiotic mixture does not enhance the postnatal decrease in intestinal permeability in preterm infants in the first week of life.
authors.affiliation: Division of Neonatology, Department of Paediatrics, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
authors.forename: Elisabeth A M
authors.initials: EA
authors.lastname: Westerbeek
authors.forename: Anemone
authors.initials: A
authors.lastname: van den Berg
authors.forename: Harrie N
authors.initials: HN
authors.lastname: Lafeber
authors.forename: Willem P F
authors.initials: WP
authors.lastname: Fetter
authors.forename: Ruurd M
authors.initials: RM
authors.lastname: van Elburg
mesh_terms: D000818:Animals; D001942:Breast Feeding; D019587:Dietary Supplements; D004311:Double-Blind Method; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D007422:Intestines / Q000502:physiology*; D008297:Male; D008892:Milk; D009844:Oligosaccharides / Q000008:administration & dosage* / Q000737:chemistry; D010539:Permeability; D056692:Prebiotics
chemical_list: D009844:Oligosaccharides; D056692:Prebiotics