title: Early enteral fat supplement and fish oil increases fat absorption in the premature infant with an enterostomy.
abstract: OBJECTIVE
  To test the hypothesis that in the premature infant with an enterostomy, early enteral supplementation with Microlipid (fat supplement) and fish oil increases enteral fat absorption and decreases the requirement for Intralipid (intravenous fat emulsion).
  
  
  METHODS
  Premature infants (<2 months old) with an enterostomy after surgical treatment for necrotizing enterocolitis or spontaneous intestinal perforation and tolerating enteral feeding at 20 mL/kg/day were randomized to usual care (control 18 infants) or early supplementing enteral fat and fish oil (treatment 18 infants). Intravenous fat emulsion was decreased as enteral fat intake was increased. Daily weight, ostomy output, and nutrition data were recorded. Weekly 24-hour ostomy effluent was collected until bowel reanastomosis, and fecal fat, fecal liquid, and dry feces were measured. Fat absorption (g/kg/d) was calculated by subtracting fecal fat from dietary fat. The fecal liquid and dry feces were reported as mg/g wet stool. Date were analyzed by using ANOVA and mixed-effects model.
  
  
  RESULTS
  The interval from initial postoperative feeding to bowel reanastomosis varied from 2 to 10 weeks. The treatment group received more dietary fat and less intravenous fat emulsion and had higher enteral fat absorption, less fecal liquid, and drier feces than the control group. These effects were greater among infants with a high ostomy compared with those with a low ostomy. Enteral fat intake was significantly correlated with fat absorption.
  
  
  CONCLUSIONS
  Early enteral fat supplement and fish oil increases fat absorption and decreases the requirement for intravenous fat emulsion. This approach could be used to promote bowel adaptation and reduce the use of intravenous fat emulsion in the premature infant with an enterostomy.
authors: Division of Neonatology, Department of Pediatrics, Wake Forest University Health Science, Winston-Salem, NC 27157, USA. qyang@wakehealth.edu
authors: Qing
authors: Q
authors: Yang
authors: Kathleen
authors: K
authors: Ayers
authors: Yuegang
authors: Y
authors: Chen
authors: Jennifer
authors: J
authors: Helderman
authors: Cherrie D
authors: CD
authors: Welch
authors: T Michael
authors: TM
authors: O'Shea
mesh_terms: D004041:Dietary Fats / Q000378:metabolism*; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage*; D019587:Dietary Supplements; D004750:Enteral Nutrition; D004766:Enterostomy; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007408:Intestinal Absorption; D008297:Male; D013997:Time Factors
chemical_list: D004041:Dietary Fats; D004042:Dietary Fats, Unsaturated; D005217:Fat Emulsions, Intravenous; D005395:Fish Oils
keywords: LCPUFA; Long-chain polyunsaturated fatty acid; Omega-3; Omega-6; PUFA; Polyunsaturated fatty acid; n-3; n-6