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Continuous gastric pH measurement in young and older healthy preterm infants receiving formula and clear liquid
Insights
Gastric pH in preterm infants increases with age. Younger preterm infants (less than 7 days) show higher gastric pH, suggesting limited peptic activity, while older infants (7-15 days) exhibit lower pH, particularly after clear liquid feedings.
Area of Science:
- Neonatal Physiology
- Gastroenterology
- Pediatric Research
Background:
- Preterm infants often experience altered gastrointestinal function.
- Gastric pH is a critical factor influencing digestive enzyme activity, such as pepsin.
- Understanding gastric pH development is essential for optimizing infant nutrition and care.
Purpose of the Study:
- To investigate the effect of postnatal age on gastric pH in preterm infants.
- To compare gastric acidity following formula and clear liquid feedings in two age groups of preterm infants.
- To assess the potential for peptic activity based on measured gastric pH levels.
Main Methods:
- Gastric pH was continuously monitored for 12 hours using an intragastric pH electrode in two groups of healthy preterm infants.
- Group I infants were less than 7 days old (n=13), and Group II infants were 7-15 days old (n=10).
- Infants received three formula and one clear liquid feeding during the monitoring period.
Main Results:
- Group I infants (younger) maintained gastric pH above 4.0 for 3 hours post-feeding.
- Group II infants (older) exhibited significantly lower gastric pH, especially after clear liquid feedings (below 4.0 for 3 hours).
- The percentage of time with gastric pH < 4.0 was substantially higher in Group II (42.7% formula, 61.9% clear liquid) compared to Group I (15.2% formula, 20.6% clear liquid).
Conclusions:
- Gastric pH in preterm infants increases with postnatal age.
- Younger preterm infants (<7 days) have gastric pH levels likely insufficient to support significant peptic activity.
- Older preterm infants (7-15 days) demonstrate increased gastric acidity, particularly after clear liquid feeds, indicating a developing digestive capacity.
Abstract:
Gastric pH was recorded with an intragastric pH electrode for 12 h in two groups of healthy, preterm infants with similar birth weights (range 1.4 to 2.0 kg). Group I infants (n = 13) were less than 7 days old and Group II infants (n = 10) were 7-15 days old. Infants were fed three formula feedings and one clear liquid feeding during the study. In Group I, mean gastric pH measured at 15-min intervals was above 4.0 for 3 h after either feeding. In Group II mean gastric pH was lower particularly after clear liquid feedings, where it remained below pH 4.0 for the entire 3-h postprandial period. The percent of monitored time at gastric pH less than 4.0 was low in Group I--15.2 +/- 4.2% and 20.6 +/- 6.4% after formula and clear liquid, respectively. The percent time was greater in Group II--42.7 +/- 8.0% and 61.9 +/- 7.3% after formula and clear liquid, respectively. In the younger preterm infant, gastric pH does not appear sufficiently low to support peptic activity.