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Faecal chymotrypsin in small for gestational age infants: effects of nucleotides and breast feeding
M Cosgrove1, H Losty, H R Jenkins
1Department of Child Health, University of Wales College of Medicine, Heath Park, Cardiff.
Insights
Breastfeeding is linked to lower fecal chymotrypsin activity (FCA) in infants, suggesting diet impacts pancreatic function. Nucleotide supplementation in formula did not alter FCA in small for gestational age infants.
Area of Science:
- Pediatric Nutrition
- Gastroenterology
- Infant Development
Background:
- Diet significantly influences pancreatic exocrine function in infants.
- The role of nucleotide supplementation in infant formula for small for gestational age (SGA) infants' growth is not fully understood, particularly concerning its impact on the gastrointestinal tract and pancreas.
- Faecal chymotrypsin activity (FCA) is a key indicator of pancreatic exocrine function.
Purpose of the Study:
- To investigate the longitudinal effect of different diets on pancreatic exocrine function in SGA infants.
- To determine if nucleotide supplementation in infant formula influences FCA in SGA infants.
- To explore the relationship between breastfeeding and FCA in early infancy.
Main Methods:
- A longitudinal study was conducted on three groups of SGA infants during their first six months of life.
- Groups included breastfed infants (Group B), infants receiving standard formula (Group S), and infants receiving formula supplemented with nucleotides (Group N).
- Faecal chymotrypsin activity (FCA) was measured periodically to assess pancreatic exocrine function.
Main Results:
- No significant differences in FCA were observed at study entry among the three groups.
- Breastfed infants (Group B) exhibited significantly lower FCA from one month onwards compared to formula-fed groups (Groups S and N).
- Nucleotide supplementation (Group N) did not significantly alter FCA compared to standard formula (Group S) at any time point.
Conclusions:
- Nucleotide supplementation in infant formula does not appear to influence pancreatic exocrine function in SGA infants.
- The growth-promoting effects of nucleotide supplementation are unlikely to be mediated through the pancreas.
- Breastfeeding is associated with lower FCA, potentially due to the lower protein content of human milk, highlighting the importance of dietary context for interpreting FCA in infants.
Abstract:
The effect of diet on pancreatic exocrine function, measured by faecal chymotrypsin activity (FCA), was studied longitudinally in three groups of small for gestational age (SGA) infants in the first six months of life. The three groups comprised breastfed infants (group B), those randomly allocated to receive a standard infant formula (group S), or the same formula supplemented with nucleotides (group N). The three groups did not differ in their birthweight or gestational age. Nucleotide supplementation of infant formula improves catchup growth in SGA infants but whether this is due to effects on the gastrointestinal mucosa or the exocrine pancreas is not known. There were no differences in FCA at study entry but by one month group B had significantly lower values than the other groups, and this was maintained at 2, 4, and 6 months. Groups N and S did not differ significantly at any time point. Nucleotide supplementation of infant formula does not influence pancreatic exocrine function and its effect on growth is unlikely, therefore, to be mediated through the pancreas. This study shows that breast feeding is associated with lower FCA which may be related to the lower protein content of human milk. Reliable interpretation of FCA in young infants requires information about their diet.