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Gastric acid secretion in preterm infants

E J Kelly1, S J Newell, K G Brownlee

  • 1Neonatal Unit, St. James's University Hospital, Leeds, UK.

Early Human Development
|December 31, 1993
PubMed

Insights

Gastric acid secretion is present in preterm infants, contrary to previous beliefs. This finding suggests that common infant gastrointestinal issues may stem from stomach acid production.

Area of Science:

  • Neonatology
  • Gastroenterology
  • Pediatric Physiology

Background:

  • The development of gastric acid secretion in preterm infants is not well understood.
  • Previous assumptions suggested preterm infants may be incapable of secreting gastric acid.

Purpose of the Study:

  • To investigate the ontogeny of gastric acid secretion in very preterm infants.
  • To determine if preterm infants can maintain a low intragastric pH.

Main Methods:

  • Continuous 24-hour intragastric pH monitoring was performed on 71 occasions in 22 enterally starved preterm infants.
  • Infants' gestational age ranged from 24 to 29 weeks.
  • Measurements were taken within the first 5 days and during the third week of life.

Main Results:

  • Intragastric pH decreased as infants matured in gestational and postnatal age.
  • Median pH values ranged from 1.8 to 3.7 on day 1 and 1.7 to 2.0 by day 16, varying by gestational group.
  • All infants successfully maintained a gastric pH below 4 from the first day.

Conclusions:

  • Preterm infants are capable of hydrogen ion secretion, refuting prior suggestions of their inability.
  • The presence of gastric acid secretion in preterm neonates likely supports normal proteolytic activity.
  • Clinical issues like gastric bleeding, gastritis, and esophagitis may be linked to intragastric acid levels.

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