Factors regulating gastric emptying in preterm infants

Area of Science:

• Neonatal physiology
• Gastroenterology
• Pediatric nutrition

Background:

• Gastric emptying (GE) is crucial for nutrient absorption in infants.
• Factors influencing GE in preterm infants are not fully understood.
• Previous studies in adults suggest osmolality, volume, and energy density impact GE.

Purpose of the Study:

• To investigate the effects of osmolality, volume, and energy density on GE in preterm infants.
• To determine if combined adjustments in osmolality and volume accelerate GE.
• To explore the relationship between GE and clinical/demographic factors in this population.

Main Methods:

• Gastric emptying (GE) was assessed using the (13)C-octanoic acid breath test in 17 preterm infants (25-30 weeks gestation).
• Study 1 evaluated independent effects of osmolality, volume, and nutrient density.
• Study 2 assessed combined effects of decreased osmolality and increased volume; statistical analyses included ANCOVA, t-tests, Wilcoxon test, and regression.

Main Results:

• Individual alterations in osmolality, volume, or energy density did not significantly alter GE.
• Simultaneously decreasing osmolality and increasing feeding volume accelerated GE by 18% compared to standard feeding.
• GE demonstrated a correlation with gestational age at birth.

Conclusions:

• In preterm infants, GE is not affected by isolated changes in osmolality, volume, or energy density.
• A strategy of reduced osmolality combined with increased feeding volume enhances GE.
• Gestational age at birth remains a significant factor influencing GE, even up to one month of age.