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Fat absorption in low birthweight infants
Insights
Newborns absorb less fat when milk is processed or calcium is high. Medium-chain triglycerides can improve fat absorption in preterm infants, addressing low lipase activity and bile salt levels.
Area of Science:
- Neonatal nutrition
- Gastroenterology
- Pediatric research
Background:
- Incomplete fat absorption is a significant issue in newborns, especially preterm infants.
- Breastfed term newborns achieve a 91% fat absorption coefficient in the first week of life.
- Processing methods like lyophilization and pasteurization decrease fat absorption in both term and preterm infants.
Purpose of the Study:
- To review factors affecting fat absorption in newborns.
- To identify limitations in neonatal fat digestion and transport.
- To explore strategies for improving fat absorption in preterm infants.
Main Methods:
- Literature review of studies on newborn fat absorption.
- Analysis of factors influencing fat absorption, including processing methods, calcium levels, and digestive enzyme activity.
- Evaluation of potential interventions for enhancing fat absorption.
Main Results:
- Excess calcium (Ca++) negatively impacts fat absorption.
- No evidence suggests immaturity in intracellular fat transport via enterocytes.
- Low pancreatic lipase activity and reduced intraluminal bile salt concentrations are key limiting factors in newborn fat absorption.
Conclusions:
- Strategies to enhance fat absorption in preterm infants are crucial.
- Substituting milk fat with medium-chain triglycerides appears to be the most effective method.
- Addressing lipase and bile salt limitations is key to improving neonatal fat assimilation.
Abstract:
Studies on the incomplete fat absorption in newborns, particularly preterm ones, are reviewed. In the first week term breastfed newborns have a fat absorption coefficient of 91%. Lyophilization or pasteurigation reduces this figure in term as well as in preterm newborns. Excess Ca++ lowers fat absorption. So far, there is no evidence of immaturity of intracellular fat transport through the enterocyte. In the newborn low pancreatic lipase activity and low intraluminal bile salt concentrations appear to limit fat absorption. The most effective method to improve fat absorption in preterm babies seems to substitute part of the milk fat by medium-chain triglycerides.