Related Experiment Videos
Human milk and the rate of small intestinal mucosal recovery in protracted diarrhea
R J Shulman1, C H Lifschitz, C Langston
1USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Houston, TX 77030.
Insights
Human milk did not accelerate the recovery of injured small intestinal mucosa in malnourished infants. Studies showed no significant difference in functional recovery between infants receiving human milk or sterile water.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Nutrition
- Intestinal Mucosal Recovery
Background:
- Infant malnutrition and protracted diarrhea can lead to small intestinal mucosal injury.
- Parenteral nutrition is often required for these infants, but its effect on mucosal recovery is a concern.
- The potential role of human milk in promoting intestinal healing warrants investigation.
Purpose of the Study:
- To investigate if human milk enhances the healing rate of injured small intestinal mucosa in infants.
- To compare the effects of human milk versus sterile water on functional recovery of the small intestine.
Main Methods:
- A randomized controlled trial was conducted in urban hospitals.
- Moderately to severely malnourished infants (<6 months) requiring parenteral nutrition were enrolled.
- Infants received either human milk preparation or sterile water via nasogastric feeding for 2 weeks.
Main Results:
- No significant differences were observed in age, illness duration, malnutrition severity, or nutritional intake between groups.
- Glucose and water absorption, lactase, and maltase activities remained comparable.
- Fewer infants in the human milk group showed improvement in sucrase activity and intraepithelial lymphocytes compared to the water group.
Conclusions:
- Human milk administration did not accelerate the functional recovery of the small intestinal mucosa in this cohort.
- The study suggests that human milk may not be superior to sterile water in promoting intestinal healing in malnourished infants receiving parenteral nutrition.
Study Objective:
To determine whether human milk accelerates the recovery rate of injured small intestinal mucosa.
Design:
Randomized, controlled trial.
Setting:
County and nonprofit, private urban hospitals.
Patients:
Moderately to severely malnourished infants less than 6 months of age who required parenteral nutrition for treatment of protracted diarrhea.
Interventions:
Either a human milk preparation (n = 7) or sterile water (n = 9) was administered by continuous nasogastric feeding (14 mL/kg/d) over a 2-week study period while the infants received parenteral nutrition.
Measurements And Main Results:
Small intestine perfusion studies and biopsies were performed at the beginning and end of the study. Age, duration of prior illness, severity of malnutrition, glucose and water absorption, disaccharidase activities, atrophy of villi, and nutritional intake were comparable in both groups of infants. At the end of the 2-week study, improvement toward normal sucrase activity and intraepithelial lymphocytes was found in significantly fewer infants in the milk group than in the water group. No differences were noted in glucose and water absorption or in lactase and maltase activities as a function of the milk versus water treatment.
Conclusions:
Human milk did not accelerate functional recovery of the small intestinal mucosa.