Absorption of lactose, glucose polymers, or combination in premature infants

R J Shulman1, A Feste, C Ou

  • 1U.S. Department of Agriculture/Agricultural Research Service (USDA/ARS) Children's Nutrition Research Center, Houston, TX, USA.

Insights

Infants absorb glucose polymers better than lactose. Lactose digestion is not affected by maturation but may be influenced by diet, unlike glucose polymers which depend on age and diet.

Area of Science:

  • Pediatric Gastroenterology
  • Neonatal Nutrition
  • Carbohydrate Metabolism

Background:

  • Infant digestion and absorption capabilities vary significantly based on gestational age and postnatal development.
  • Understanding carbohydrate assimilation is crucial for optimizing infant nutrition, especially in premature infants.

Purpose of the Study:

  • To compare the digestion and absorption of lactose, a lactose-glucose polymer combination, and glucose polymers alone in preterm infants.
  • To investigate the influence of postnatal age, feeding history, and diet on carbohydrate absorption in this population.

Main Methods:

  • A double-lumen perfusion catheter was used in the duodenum-jejunum of infants (28-42 weeks gestation).
  • Infants received three carbohydrate solutions (lactose, lactose-glucose polymers, glucose polymers) in random order.
  • Absorption was quantified by the disappearance of carbohydrates and their components.

Main Results:

  • Lactose absorption was significantly lower compared to lactose-glucose polymers and glucose polymers alone.
  • Glucose polymer absorption correlated with postnatal age and duration of full-strength feedings, unlike lactose absorption.
  • Lactose absorption was higher in infants fed formula alone versus formula with human milk.

Conclusions:

  • Premature infants exhibit less efficient digestion and absorption of lactose compared to glucose polymers.
  • Lactose does not impede glucose polymer absorption, but its own assimilation is not maturation-dependent.
  • Glucose polymer absorption is influenced by both infant maturation and dietary factors, while lactose absorption may be more sensitive to diet type.
Abstract

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