Related Experiment Videos
Dietary carbohydrate assimilation in the premature infant: evidence for a nutritionally significant bacterial
Insights
Colonic fermentation is crucial for premature infants fed lactose, aiding energy absorption and preventing diarrhea. Studies show lactose and glucose polymer formulas support carbohydrate absorption without adverse effects.
Area of Science:
- Neonatal Nutrition
- Gastroenterology
- Microbiology
Background:
- Premature infants have immature digestive systems.
- Lactose is a primary carbohydrate in infant formulas.
- Colonic fermentation's role in premature infant nutrition is not fully understood.
Purpose of the Study:
- To assess carbohydrate energy absorption in premature infants.
- To measure breath hydrogen concentration as an indicator of colonic fermentation.
- To compare lactose versus a lactose/glucose polymer formula.
Main Methods:
- 12 premature infants (28-32 wk gestational age) were fed either 100% lactose or 50% lactose/50% glucose polymer formula.
- Breath hydrogen concentration and carbohydrate energy absorption were measured.
- Infants were monitored for gastrointestinal symptoms.
Main Results:
- Peak breath hydrogen concentrations indicated extensive colonic fermentation in most infants.
- Increased lactose intake correlated with higher breath hydrogen levels.
- Carbohydrate energy absorption was high and similar between groups (86% vs. 91%).
- No infants experienced diarrhea, vomiting, or delayed gastric emptying.
Conclusions:
- Colonic bacterial fermentation plays a vital role in energy balance for premature infants.
- Fermentation may prevent osmotic diarrhea in infants fed lactose.
- Both formulas supported adequate carbohydrate absorption.
Abstract:
Carbohydrate energy absorption and breath hydrogen concentration were measured in 12 premature infants 28-32 wk gestational age and 2-4 wk postnatal age. Each of two groups of six infants were randomly assigned to receive one of two formulas that differed only in carbohydrate source: 100% lactose (LAC) or 50% lactose: 50% glucose polymer (LAC + GP). In 11 infants the peak breath hydrogen concentration suggested extensive colonic fermentation (range 44-239 ppm/5% CO2 or 44-239 microL/L per 50 mL/L CO2). An approximate 100% increase in lactose intake in the LAC group was associated with a similar increase in breath hydrogen concentration at 30, 60, and 120 min. None of the infants exhibited diarrhea or vomiting or developed delayed gastric emptying. Carbohydrate energy absorption (mean +/- SD) was, respectively, 86 +/- 5% and 91 +/- 3% in the LAC and the LAC + GP groups (p greater than 0.05). Thus, colonic bacterial fermentation may be critical to energy balance and to the prevention of osmotic diarrhea in premature infants fed lactose.