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Antral and duodenal motor responses to duodenal feeding in preterm and term infants
1Department of Pediatrics, Mayo Clinic, Rochester, Minnesota 55095.
Insights
Gastric motor activity in preterm and term infants differs during feeding, with antral activity decreasing and duodenal activity increasing in response to milk infusion.
Area of Science:
- Neonatology
- Gastroenterology
- Physiology
Background:
- Fasting antral motor activity is similar in preterm and term infants.
- Duodenal motor activity, however, differs, with shorter cluster durations in preterm infants.
Purpose of the Study:
- To compare antral and duodenal feeding responses in preterm and term infants.
- To investigate the effects of intraduodenal milk infusion on gastric motility.
Main Methods:
- Low-compliance, continuous perfusion manometry was used.
- 13 preterm and 9 term infants were studied within 14 days of life.
- Intraduodenal milk infusion (4 ml/kg/2 h) was administered.
Main Results:
- Both preterm and term infants showed changes in antral and duodenal motor activity post-feeding.
- Term infants exhibited decreased antral activity (pressure waves, cluster duration, motility index) during feeding.
- Term infants showed increased duodenal motility index and cluster activity during feeding.
- Preterm infants demonstrated a similar divergent response with decreased antral activity.
Conclusions:
- Antral and duodenal motor responses to feeding diverge in both preterm and term infants.
- Feeding decreases antral activity while increasing duodenal activity.
- These findings highlight developmental differences in gastrointestinal motility regulation.
Abstract:
In the fasting state, antral motor activity is similar in preterm and term infants, but the antral responses to feeding have not been compared in preterm and term infants. The purpose of this study was to use low-compliance, continuous perfusion manometry to compare antral and duodenal feeding responses in 13 preterm and nine term infants within the first 14 days of life. Confirming our previous studies, fasting antral motor activity was similar in preterm and term infants, but duodenal activity differed. Individual duodenal cluster activity was of shorter duration in preterm than in term infants (p less than 0.01). Motor activity in antrum and duodenum changed in both groups of infants in response to an intraduodenal milk infusion of 4 ml/kg/2 h; however, the nature of the change varied in the two regions. In term infants, the number of antral pressure waves, the duration of antral clusters, and the antral motility index decreased by one third or more during feeding when compared with fasting (all p less than 0.05). In contrast to the decrease in antral activity in response to feeding, the duodenal motility index and cluster activity increased significantly during feeding compared with fasting (both p less than 0.05). The divergent response of antral and duodenal motor activity in response to feedings was also seen in preterm infants. Antral pressure waves, the duration of antral clusters, and the antral motility index were decreased during feeding (all p less than 0.005 or less).(ABSTRACT TRUNCATED AT 250 WORDS)