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Published on: August 6, 2018
Absorption of lactose, glucose polymers, or combination in premature infants
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.
Study Objective:
To determine the digestion and absorption of lactose, a combination of lactose and glucose polymers, and glucose polymers alone in infants born at 28 to 42 weeks of gestation.
Design:
Each infant received the three carbohydrate solutions (85 gm/L concentration) in random order.
Setting:
Tertiary care urban children's hospital.
Interventions:
A double-lumen perfusion catheter was placed in the duodenum-jejunum. Absorption was defined as the disappearance of the carbohydrate and all its components (e.g., for lactose: galactose, glucose).
Measurements And Main Results:
Absorption of lactose was less than that of the lactose-glucose polymer combination and the glucose polymers alone. There was no relationship between lactose absorption and postnatal age, whereas absorption of the lactose-glucose polymer combination and the glucose polymers alone correlated with age. Lactose absorption was not related to the number of days that the infants received full-strength feedings or the total number of days of feeding before the study, whereas absorption of both the lactose-glucose polymer combination and the glucose polymers alone was related to both. Absorption of the three solutions was not related to gestational age or to the number of days before the initial feeding. Lactose absorption was greater in infants who received formula alone than in infants fed formula together with human milk.
Conclusions:
Premature infants do not digest and absorb lactose as well as glucose polymers. However, lactose does not impair the absorption of glucose polymers. Lactose assimilation is not affected by maturation, but the type of diet may affect lactose digestion and absorption. In contrast, digestion and absorption of glucose polymers are related to both postnatal age and diet.
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