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Meal-stimulated gastric acid secretion in infants
Insights
Newborn infants show a weaker, yet similar, acid secretion response to a mixed meal compared to older children and adults. This study measured gastric acid output in infants after feeding.
Area of Science:
- Gastroenterology
- Pediatric Physiology
- Neonatal Nutrition
Background:
- Gastric acid secretion is crucial for nutrient digestion and pathogen defense.
- Understanding acid production in newborns is vital for assessing digestive health.
- Limited data exists on the response to mixed meals in early infancy.
Purpose of the Study:
- To quantify and compare gastric acid output in newborn infants versus older infants after a mixed meal.
- To characterize the time course of the acid secretory response to an elemental formula in newborns.
- To establish normative data for gastric acid production in healthy neonates.
Main Methods:
- Gastric acid output was measured using nasogastric infusion of 5% glucose and elemental formula.
- Basal and meal-stimulated acid output were assessed in healthy newborn infants (n=8).
- Acid output was also measured in older infants (n=6, age 6-31 months) for comparison.
Main Results:
- Newborns exhibited significantly lower basal (0.038 +/- 0.008 mmol/kg/hr) and meal-stimulated (0.064 +/- 0.011 mmol/kg/hr) acid output compared to older infants.
- Older infants had basal acid output of 0.067 +/- 0.017 mmol/kg/hr and meal-stimulated output of 0.149 +/- 0.038 mmol/kg/hr.
- The elemental formula elicited a sustained acid secretion increase in newborns, similar in pattern but reduced in magnitude compared to adults.
Conclusions:
- Human newborn infants demonstrate a functional, albeit diminished, gastric acid secretory capacity in response to a mixed meal.
- The observed response pattern is qualitatively similar to that of older infants and adults, suggesting developmental maturation of the secretory mechanism.
- These findings provide critical insights into neonatal digestive physiology and the maturation of gastric acid production.
Abstract:
Basal acid output and meal-stimulated acid output were measured in newborn infants after nasogastric infusion of 5% glucose and elemental formula, respectively. In six older infants (age range 6 to 31 months), basal acid output was 0.067 +/- 0.017 mmol/kg/hr and maximal acid output was 0.200 +/- 0.028 mmol/kg/hr. Meal-stimulated acid output in four of six older infants was 0.149 +/- 0.038 mmol/kg/hr. In eight healthy newborn infants basal acid output was 0.038 +/- 0.008 mmol/kg/hr; meal-stimulated acid output was 0.064 +/- 0.011 mmol/kg/hr (P less than 0.01). The time course of the secretory response to the elemental formula was as described previously after a protein meal in adults: the rate of acid secretion increased after 20 minutes and remained greater than the basal rate through the remainder of the 90 minute test period. These results demonstrate that in human newborn infants a mixed meal containing protein hydrolysate induces an acid secretory response that is qualitatively similar to but weaker than the response in older infants and adults.