Related Experiment Videos
Minimal enteral nutrient requirements for intestinal growth in neonatal piglets: how much is enough?
1US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA. dburrin@bcm.tmc.edu
Insights
Minimal enteral nutrition is crucial for neonatal intestinal growth. At least 40% of nutrient intake enterally is needed to increase intestinal mass, with 60% required for normal proliferation and growth.
Area of Science:
- Neonatal physiology
- Gastroenterology
- Pediatric nutrition
Background:
- Parenteral nutrition is common in preterm infants, often supplemented with minimal enteral feedings to improve gut function.
- The impact of minimal enteral nutrition on intestinal growth in neonates remains unclear.
Purpose of the Study:
- To determine the minimum enteral nutrient intake required to stimulate and normalize intestinal growth in neonates.
- Investigate the dose-dependent effects of enteral nutrition on intestinal development.
Main Methods:
- Neonatal pigs received varying percentages (0-100%) of their total nutrient intake via enteral feeding for 7 days, with the remainder provided parenterally.
- Quantified intestinal growth parameters including wet weight, protein mass, villus height, and cell proliferation markers.
Main Results:
- Enteral intakes exceeding 40% significantly increased jejunal wet weight, protein mass, and villus height.
- Ileal protein mass stimulation required 60% enteral intake.
- Significant increases in DNA mass, crypt depth, and cell proliferation markers occurred between 40% and 60% enteral intake.
- Hormonal changes (GLP-2, PYY) correlated with cell proliferation.
Conclusions:
- A minimum of 40% of total nutrient intake must be delivered enterally to promote intestinal mucosal mass.
- 60% enteral nutrition is necessary to achieve normal mucosal proliferation and growth in neonatal pigs.
- Enteral intakes below 40% show limited trophic effects on the neonatal intestine.
Background:
Parenterally nourished preterm infants commonly receive minimal enteral feedings, the aim being to enhance intestinal function. Whether this regimen increases intestinal growth has not been established.
Objective:
Our objective was to determine the minimal enteral nutrient intakes necessary to stimulate and to normalize neonatal intestinal growth.
Methods:
Intestinal growth and cell proliferation were quantified in neonatal pigs given equal amounts of an elemental nutrient solution for 7 d. Different groups (n = 5-7 per group) received 0%, 10%, 20%, 40%, 60%, 80%, or 100% of total nutrient intake enterally, with the remainder given parenterally.
Results:
In the jejunum, wet weight, protein mass, and villus height were significantly greater at enteral intakes >40%. Stimulation of ileal protein mass required a higher enteral intake (60%). In both segments, abrupt increases in DNA mass, crypt depth, ornithine decarboxylase activity, and crypt cells in S-phase occurred between enteral intakes of 40% and 60%. Circulating concentrations of glucagon-like peptide-2 and peptide YY, but not gastrin, increased significantly between enteral intakes of 40% and 60% and closely paralleled indexes of cell proliferation.
Conclusions:
The minimal enteral nutrient intake necessary to increase mucosal mass was 40% of total nutrient intake, whereas 60% enteral nutrition was necessary to sustain normal mucosal proliferation and growth. Our results imply that providing <40% of the total nutrient intake enterally does not have significant intestinal trophic effects.