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Gastric emptying in preterm infants

A K Ewer1, G M Durbin, M E Morgan

  • 1Maternity Hospital, Birmingham.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|July 1, 1994
PubMed
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Expressed breast milk empties twice as fast as formula milk in preterm infants. This faster gastric emptying of breast milk may improve feeding tolerance in vulnerable newborns.

Area of Science:

  • Neonatal Physiology
  • Gastroenterology
  • Pediatric Nutrition

Background:

  • Preterm infants often experience feeding intolerance due to delayed gastric emptying.
  • Understanding factors influencing gastric emptying is crucial for optimizing nutrition in neonates.
  • Breast milk is the preferred nutrition source for preterm infants, but its effect on gastric emptying requires further elucidation.

Purpose of the Study:

  • To compare gastric emptying rates between expressed breast milk and formula milk in preterm infants.
  • To evaluate the reproducibility of an ultrasonic technique for assessing gastric emptying.
  • To determine the clinical implications of differential gastric emptying for feeding intolerance in neonates.

Main Methods:

  • A blind, cross-over study design was employed with 14 preterm infants (median gestational age 33 weeks).

Related Experiment Videos

  • Gastric emptying was assessed using real-time ultrasound to measure antral cross-sectional area (ACSA) changes post-feed.
  • Half emptying time (50% delta ACSA) was calculated, representing the time for ACSA to reduce by half its post-feed increment.

    • Main Results:

    • Expressed breast milk demonstrated significantly faster gastric emptying compared to formula milk (mean 50% delta ACSA: 36 minutes vs. 72 minutes).
    • The ultrasonic technique proved reproducible, with consistent emptying rates for individual infants across feeds of the same type.
    • Gastric emptying of expressed breast milk was approximately twice as rapid as that of formula milk.

    Conclusions:

    • Breast milk significantly accelerates gastric emptying in preterm infants compared to formula.
    • This finding suggests a potential mechanism for improved feeding tolerance with breast milk in this population.
    • The ultrasonic method is a reliable tool for assessing gastric emptying dynamics in preterm neonates.