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Timing of the gut closure
Insights
Starting breast-feeding (BF) early in newborns promotes gut closure for macromolecules. Delayed BF may prevent spontaneous gut closure within the first 30 hours of life, impacting nutrient absorption.
Area of Science:
- Neonatal Physiology
- Immunology
- Gastroenterology
Background:
- The earliest postnatal period is critical for establishing gut barrier function.
- Gut closure to macromolecules is essential for preventing immune reactions and ensuring proper nutrient absorption.
- Breast-feeding (BF) is known to influence neonatal gut development and immune function.
Purpose of the Study:
- To investigate the impact of the timing of initiating breast-feeding (BF) on gut closure for macromolecules in newborns.
- To determine if early BF influences the rate at which the neonatal gut seals to prevent macromolecular absorption.
Main Methods:
- Serum IgA concentrations were measured in neonates as an indicator of gut permeability to macromolecules.
- Three groups of neonates were studied based on the timing of BF initiation: early (1-6 hours), intermediate (12-15 hours), and late (24-29 hours).
- Serum IgA levels were assessed before and after defined periods of BF.
Main Results:
- Neonates with early BF initiation (1-6 hours) showed a significant decrease in serum IgA concentrations by day 3, indicating early gut closure.
- A significant increase in serum IgA was observed in 11 out of 20 neonates whose BF was initiated after 24 hours, suggesting delayed or absent spontaneous gut closure.
- The duration of BF was shortest in the late-initiation group, yet serum IgA levels rose, highlighting the effect of delayed initiation.
Conclusions:
- Early initiation of breast-feeding (BF) appears to promote timely gut closure for macromolecules in neonates.
- Postponing BF beyond 24-29 hours of life may hinder spontaneous gut closure within the critical first 30 hours.
- These findings underscore the importance of early BF for establishing neonatal gut barrier function and potentially preventing adverse immunological outcomes.
Abstract:
This study was designed to establish whether the starting time of breast-feeding (BF) may have affected gut closure for macromolecules during the earliest postnatal period. An increase of serum IgA concentrations was taken as the index of gut permeability to macromolecules. In 14 neonates, BF started 1-6 h after birth and continued every 3 h during the next 38-48 h; in 19 neonates, it started 12-15 h after birth, continuing in the following 34-46 h; and in 20 neonates, BF started at the age of 24-29 h and continued during the next 18-36 h. Serum IgA concentrations were measured before and after the period of BF using the method of single radial immunodiffusion on commercial plates. In neonates in which BF started earlier, serum IgA concentrations fell significantly (p less than 0.001) until the 3rd day of life. This suggested an early gut closure, caused either by some colostral factor(s) or, perhaps, by some other mechanism which prevented further macromolecular absorption. In 11 of 20 neonates in which BF started after 24 h of life, even though in this group of babies, it was of the shortest duration, serum IgA concentrations increased significantly (p less than 0.001), suggesting that if BF is postponed, a spontaneous gut closure may not take place within the first 30 h of life.