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Intestinal permeability changes during the first month: effect of natural versus artificial feeding
Insights
Newborn intestinal permeability significantly decreases within the first month of life. Breast-fed infants exhibit faster gut closure compared to those receiving artificial formulas.
Area of Science:
- Neonatal physiology
- Gastroenterology
- Developmental biology
Background:
- Intestinal permeability is crucial for nutrient absorption and immune function in neonates.
- Understanding the developmental changes in gut permeability is essential for infant health.
- Feeding patterns may influence the maturation of the neonatal gut barrier.
Purpose of the Study:
- To investigate the impact of age and feeding methods on intestinal permeability in the first month of life.
- To compare the intestinal permeability of exclusively breast-fed neonates with those fed artificial formulas.
- To analyze the developmental trajectory of sugar intestinal permeability in healthy term infants.
Main Methods:
- A cohort of 72 healthy, full-term neonates was divided into exclusively breast-fed (BF) and artificially fed (CM) groups.
- Intestinal permeability was assessed using a lactulose/mannitol (lac/man) test at 1, 7, and 30 days of life.
- Urinary lactulose and mannitol levels were quantified via High-Performance Liquid Chromatography (HPLC).
Main Results:
- The mean urinary lac/man ratio decreased significantly from 1.27 at day 1 to 0.22 at day 30.
- At 7 days, breast-fed infants had a lower lac/man ratio (0.22) compared to formula-fed infants (0.47).
- Intestinal permeability showed a developmental pattern similar to gut closure observed in other mammalian species.
Conclusions:
- Neonatal intestinal permeability undergoes rapid development, decreasing significantly in the first month.
- Breast-feeding promotes a faster decrease in intestinal permeability compared to adapted or hypoallergenic formulas.
- The findings suggest that feeding practices play a significant role in neonatal gut maturation.
Abstract:
The aim of the study was to investigate the effect of age and feeding pattern on intestinal permeability during the first month of life. The subjects were 72 full-term, healthy neonates who were (a) exclusively breast-fed (BF group, n = 36) or (b) artificially fed (CM group, n = 36) with either an adapted formula (AF group, n = 17) or a partly hydrolyzed (hypoantigenic) formula (HA group, n = 19). A lactulose/mannitol (lac/man) intestinal permeability test was performed at 1 and 7 days (steady-state method, n = 72), then at 30 days of life (single oral load, n = 47). Urinary lactulose and mannitol were measured by HPLC. The mean lac/man urinary ratio dropped from 1.27 +/- 0.73 (day 1) to 0.34 +/- 0.36 at day 7 and to 0.22 +/- 0.21 at day 30. At 7 days BF infants showed a significantly lower lac/man urinary ratio (0.22 +/- 0.25) than the CM group (0.47 +/- 0.41). The human neonate shows a developmental pattern of sugar intestinal permeability that resembles gut closure observed in other mammals. Intestinal permeability decreases faster in breast-fed babies than in those fed with adapted or HA formulas.