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Neonatal small intestinal motility: motor responses to feeding in term and preterm infants
1Department of Pediatrics, Mayo Clinic, Rochester, Minnesota 55905.
Insights
Preterm infants
Area of Science:
- Neonatal physiology
- Gastrointestinal motility
Background:
- Infants, particularly preterm infants, may exhibit immature fasting patterns in their intestinal motility.
- Understanding the intestinal motor response to feeding is crucial for optimizing infant nutrition.
Purpose of the Study:
- To investigate if the intestinal motor response to intraduodenal feeding is preserved in preterm infants despite immature fasting patterns.
- To compare the feeding-induced motor activity between preterm and term infants.
Main Methods:
- Low-compliance, continuous-infusion manometry was employed in 13 term and 23 preterm infants during the first postnatal week.
- Standard formula was administered intraduodenally via infusion pump at a rate of 4 ml/kg/2 hr.
- Changes in motility index, pressure peak frequency, amplitude, and quiescence duration were analyzed.
Main Results:
- Small bowel motility in both preterm and term infants shifted from fasting patterns to persistent activity upon feeding.
- No significant differences in motor activity response to feeding were observed between preterm and term infants.
- The number of pressure peaks per 30-minute period was identified as the most sensitive indicator of the fed motor response.
Conclusions:
- The preterm infant intestine demonstrates an appropriate motor response to intraduodenal feeding, even with immature fasting patterns.
- These findings support the tolerance and use of antral feedings in preterm infants.
- The study highlights the robustness of the intestinal feeding response in early infancy.
Abstract:
To explore the possibility that the intestinal motor response to feeding is intact even in infants with immature fasting patterns, we performed low-compliance, continuous-infusion manometry in 13 term and 23 preterm infants during the first postnatal week. Babies were fed a standard formula intraduodenally at 4 ml/kg/2 hr by infusion pump. Small bowel motility responded to feeding; fasting patterns were replaced with long periods of persistent activity. During the infusion of formula, there was no significant difference in motor activity between preterm and term infants. Four characteristics of motor activity changed with feeding: motility index, the number of pressure peaks per 30-minute period, mean amplitude of pressure peaks, and duration of periods of quiescence. The number of pressure peaks per 30-minute period was the most sensitive index of the motor response to feeding, and it was used to characterize the fed pattern response. The start and duration of the fed response were similar in both groups of infants. Thus, despite the presence of immaturity in fasting patterns, the intestine of the preterm infant responds appropriately to feeding. These data help explain why preterm infants usually tolerate antral feedings, and support their use.