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Short-Term Gastrointestinal Tolerance and Oxygenation Changes After a Locust Bean Gum-Containing Formula in Preterm

Murat Konak1, Evrim Kılıçlı1, Saime Sündüs Uygun1

  • 1Division of Neonatology, Department of Pediatrics, Selçuklu Medical Faculty, Selçuk University, Konya 42000, Türkiye.

Nutrients
|June 12, 2026
PubMed

Insights

Locust bean gum (LBG) formula improved gastrointestinal tolerance and oxygenation in preterm infants. Younger infants (postmenstrual age < 34 weeks) showed the greatest benefits, warranting further study.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Nutritional Science

Background:

  • Gastrointestinal dysmotility and respiratory instability are prevalent in preterm infants.
  • Locust bean gum (LBG) formulas are used for regurgitation, but their short-term GI tolerance effects are unclear.
  • This study investigates LBG formula impact on GI tolerance and oxygenation in NICU settings.

Purpose of the Study:

  • To evaluate short-term changes in gastrointestinal tolerance and oxygenation after initiating an LBG-containing formula.
  • To explore if postmenstrual age (PMA) influences the response to LBG formula.
  • To assess the efficacy of LBG formula in improving GI symptoms and respiratory stability.

Main Methods:

  • Retrospective paired cohort study of 26 preterm infants receiving LBG formula.
  • Standardized scores for stool consistency, straining, distension, gas, tenderness, SpO2, and desaturation frequency were recorded.
  • Paired comparisons (Wilcoxon signed-rank test) and PMA-stratified analysis (Kruskal-Wallis) were employed.

Main Results:

  • Significant improvements observed by Day 7: 96.2% had soft stools, 87.5% resolved severe straining, 96.2% improved abdominal distension, and all normalized gas passage.
  • Mean SpO2 category improved significantly (p=0.0023), with increased infants having rare/no desaturations (61.5% to 96.2%).
  • Infants with PMA < 34 weeks exhibited the most substantial improvements across all measured outcomes.

Conclusions:

  • Initiating LBG-containing formula is linked to short-term improvements in GI tolerance and oxygenation in preterm infants.
  • Exploratory analysis suggests PMA may influence response, indicating potential heterogeneity.
  • Further prospective studies with larger sample sizes are needed to confirm these findings and explore PMA-related differences.

Keywords:
anti-regurgitation formulafeeding tolerancelocust bean gumneonatal nutritionoxygen saturationpostmenstrual agepreterm infant

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