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Changes in gastric emptying in early postnatal life
M A Carlos1, P S Babyn, M A Marcon
1Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Insights
Gastric emptying patterns in very premature infants vary with postnatal age and feeding tolerance. Understanding these differences can inform better feeding strategies for these vulnerable infants.
Area of Science:
- Neonatal Physiology
- Gastroenterology
- Pediatric Imaging
Background:
- Premature infants often experience feeding difficulties.
- Gastric emptying is crucial for nutrient absorption and growth in neonates.
Purpose of the Study:
- To investigate gastric emptying patterns in very premature infants.
- To assess changes in gastric emptying with advancing postnatal age.
- To correlate gastric emptying with feeding tolerance.
Main Methods:
- Ultrasound measurements of gastric antral cross-sectional area in 32 very premature infants.
- Assessment of gastric emptying parameters including time to maximal distention and half-antral clearance.
- Studies conducted at different postnatal ages and feeding statuses.
Main Results:
- Delayed gastric emptying observed initially in both feeding-tolerant and intolerant infants.
- Significant differences in gastric emptying times between feeding-tolerant and intolerant groups.
- All infants demonstrated mature gastric emptying patterns by 32 weeks corrected age.
Conclusions:
- Distinct gastric emptying patterns exist in very premature infants.
- Postnatal age and feeding tolerance significantly influence gastric emptying.
- These findings support the development of individualized feeding strategies.
Objective:
To study the pattern of gastric emptying in very premature infants and to determine whether there are changes with postnatal age and the ability to tolerate feedings.
Methods:
Sequential ultrasound measurements of the gastric antral cross-sectional area were obtained in 32 infants (mean gestational age, 26 +/- 1 weeks) before and after feeding for 2 hours. Studies were carried out after initiation of feedings, when full feedings were received, and at 32 weeks. Infants classified as feeding intolerant (n = 9) were also studied when feedings were restarted. Gastric emptying was assessed by the time taken for antral cross-sectional area to reach maximal value and to decrease to half the maximal increment (half-antral clearance).
Results:
Delayed antral distention was observed at the time of the initial study in both feeding-tolerant (8 of 23) and feeding-intolerant (8 of 9) infants; however, there were significant differences in times for maximal antral distention (p < 0.002) and half-antral clearance (p < 0.006) between the feeding-tolerant and feeding-intolerant infants. By the time of full feedings, the feeding-intolerant infants showed immediate gastric emptying but still had a longer half-antral clearance time (p < 0.01). By 32 weeks, all infants had immediate antral distention and a more mature curvilinear pattern of gastric emptying.
Conclusions:
Knowledge of these different patterns of gastric emptying in very premature infants may lead to the development of more rational feeding strategies.