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[Gastrointestinal hormones during minimal enteral feeding of sick premature infants]
M R Ordaz-Jiménez1, J M Fernández-Celis, S Rivera-Rosas
1Servicio de Neonatología del Hospital General del Centro Médico Nacional, La Raza Instituto Mexicano del Seguro Social, México, D.F., México.
Insights
Minimal enteral feeding (MEF) stimulates gastrointestinal hormone secretion in premature infants. Early MEF appears more beneficial than late MEF, without increasing complications.
Area of Science:
- Neonatalogy
- Gastroenterology
- Pediatric Nutrition
Background:
- Premature infants often require nutritional support via total parenteral nutrition (TPN).
- Assessing gastrointestinal hormonal response (GHR) to enteral feeding is crucial for growth and development.
- Minimal enteral feeding (MEF) is a strategy to initiate gut stimulation.
Purpose of the Study:
- To evaluate the gastrointestinal hormonal response (GHR) to minimal enteral feeding (MEF) in sick premature infants.
- To compare the effects of early versus late initiation of MEF on GHR.
Main Methods:
- Forty-one premature infants (<1800g birth weight) receiving TPN were divided into early (<=5 days) and late (10-14 days) enteral feeding groups.
- MEF involved a diluted formula, starting at 1 mL/hr and increasing daily.
- GHR was measured before and after the MEF intervention.
Main Results:
- All measured gastrointestinal hormones showed significant changes from basal to final levels within both groups.
- These hormonal changes were observed across different gestational ages and infant weights.
- No abdominal complications were associated with the MEF protocol.
Conclusions:
- Minimal enteral feeding (MEF) effectively promotes gastrointestinal hormone secretion in sick premature infants.
- Early initiation of MEF appears to enhance hormone secretion more rapidly compared to late initiation.
- MEF is a safe feeding strategy for premature infants, not leading to increased abdominal issues.
Objective:
To measure gastrointestinal hormonal response (GHR) with minimal enteral feeding (MEF) in sick premature infants.
Methods:
Forty-one babies birth weight < 1800 g receiving total parenteral nutrition or intravenous solutions entered the study. They were distributed in two groups: group I: 26 infants (early enteral feeding < or = 5 d) and group II = 15 infants (late enteral feeding = 10-14 d). A diluted special formula was used as MEF starting with 1 mL hourly with daily increments of 1 mL up to 120 mL. Basal and final determinations of GHR were done before and after the MEF.
Results:
Both groups were similar in birth weight, postnatal age, and trophism. There were intragroup differences between basal and final GHR for all hormones in both groups. Subgroups by gestational age (< or = 32 vs > 32 weeks) and trophism (< or = 1250 vs > 1250 g) also showed basal-final differences. There were no complications related to the MEF.
Conclusions:
MEF favors secretion of gastrointestinal hormones in sick premature infants. Early MEF seems to be preferable to late one since it allows a faster secretion related to volume of the formula. MEF did not increase abdominal complications in our infants.