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Pancreatic endocrine response to the first feed in term newborn infants
Insights
Newborn infants
Area of Science:
- Neonatal physiology
- Endocrinology
- Metabolic studies
Background:
- Neonatal metabolic adaptation is critical for infant survival.
- Understanding hormonal responses to feeding in newborns informs clinical practice.
- The C-peptide to insulin ratio in neonates differs from adults due to physiological factors.
Purpose of the Study:
- To investigate the metabolic and hormonal responses of term newborn infants to their first feed.
- To compare the effects of milk versus glucose feeds on blood glucose and hormone levels.
- To assess the impact of varying fasting durations on these responses.
Main Methods:
- Blood glucose, insulin, C-peptide, and glucagon levels were measured in 36 term newborns.
- Measurements were taken at birth, before feeding, and 60 minutes after the first feed.
- Infants received either a milk-based formula or a glucose solution, with varying pre-feed fasting periods (6, 12, or 24 hours).
Main Results:
- Basal glucose levels decreased, while glucagon increased during the first day of life.
- Milk feeding led to greater increases in blood glucose, insulin, and C-peptide compared to glucose feeding.
- Glucagon levels did not significantly change post-feed, irrespective of feed type.
Conclusions:
- The first feed significantly impacts glucose and insulin dynamics in newborns.
- Milk-based feeds elicit a more robust hormonal response than glucose solutions.
- Neonatal renal function may influence the C-peptide to insulin ratio.
Abstract:
Blood glucose, insulin, C-peptide and glucagon were evaluated in 36 newborn term infants at birth, and before and 60 min after the first feed during the first day of life. Under basal conditions glycaemia diminished during the first day of life and glucagon increased, while insulin and C-peptide did not show any variation. The C-peptide: insulin molar ratio was higher in the newborn than in adults because of the longer half-life of C-peptide, probably due to reduced renal function in the neonatal period. The subjects were divided into two groups: 18 newborn infants were given a feed of commercially available milk powder reconstituted in water at 10% (5 ml/kg); the other 18 were given a feed of 5 ml/kg 10% glucose solution. In each group 6 were given the first feed after a fast of 6 h, 6 after a fast of 12 h and 6 after a fast of 24 h from birth. After the first feed with milk, the average increase of glycaemia was 19.83 mg%, of insulin 6.06 muU/ml, and of C-peptide 1.88 ng/ml. After the first feed with glucose the average increase of glycaemia was 13.59 mg%, of insulin 2.46 muU/ml, and of C-peptide 0.59 ng/ml. Glucagon did not show significant changes after the first feed.