title: Breast-feeding improves gut maturation compared with formula feeding in preterm babies.
abstract: OBJECTIVE
  The incidence of necrotizing enterocolitis (NEC) is higher in formula-fed babies than in breast-fed babies, which may be caused by breast-feeding-induced gut maturation. The effect of breast-feeding on gut maturation has been widely studied in animal models. This study aimed to assess the effects of breast-feeding on intestinal maturation in prematurely born babies by evaluating postnatal changes in urinary intestinal fatty acid binding protein (I-FABP) levels, a specific enterocyte marker.
  
  
  METHODS
  Gut maturation in 40 premature babies (<37 weeks of gestation) without gastrointestinal morbidity was studied, of whom 21 were exclusively breast-fed and 19 were formula-fed infants. Urinary I-FABP levels as the measure of gut maturation were measured at 5, 12, 19, and 26 days after birth.
  
  
  RESULTS
  In breast-fed infants, there was a significant increase in median urinary I-FABP levels between 5 and 12 days after birth (104 [78-340] pg/mL to 408 [173-1028] pg/mL, P = 0.002), whereas I-FABP concentration in formula-fed infants increased between 12 and 19 days after birth (105 [44-557] pg/mL, 723 [103-1670] pg/mL, P = 0.004). Breast-fed babies had significantly higher median urinary I-FABP levels at postnatal day 12 (P = 0.01).
  
  
  CONCLUSIONS
  The time course of the postnatal increase in urinary I-FABP levels reflecting gut maturation was significantly delayed in formula-fed babies, suggesting a delayed physiological response in formula-fed compared with breast-fed infants.
authors.affiliation: *Department of Surgery, Maastricht University Medical Center and Nutrition and Toxicology Research Institute †Department of Pediatrics, Maastricht University Medical Center and School for Oncology and Developmental Biology, Maastricht, The Netherlands.
authors.forename: Kostan W
authors.initials: KW
authors.lastname: Reisinger
authors.forename: Loes
authors.initials: L
authors.lastname: de Vaan
authors.forename: Boris W
authors.initials: BW
authors.lastname: Kramer
authors.forename: Tim G A M
authors.initials: TG
authors.lastname: Wolfs
authors.forename: L W Ernest
authors.initials: LW
authors.lastname: van Heurn
authors.forename: Joep P M
authors.initials: JP
authors.lastname: Derikx
mesh_terms: D015415:Biomarkers / Q000652:urine; D001942:Breast Feeding; D050556:Fatty Acid-Binding Proteins / Q000652:urine; D005243:Feces / Q000737:chemistry; D005260:Female; D005865:Gestational Age; D006801:Humans; D041943:Infant Formula; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007422:Intestines / Q000254:growth & development*; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008297:Male; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins; D039841:Leukocyte L1 Antigen Complex