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Hunger behaviour contributes to early nutritional homeostasis
G Marchini1, B Persson, V Berggren
1Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden.
Insights
Newborns experience weight loss and metabolic shifts in the first few days of life, with feeding behavior adjusting to maintain nutritional balance. Breastfeeding on demand supports this homeostasis.
Area of Science:
- Neonatal physiology
- Infant nutrition
- Metabolic adaptation
Background:
- Understanding nutritional homeostasis in newborns is crucial for infant health.
- Early life metabolic changes impact infant well-being and development.
Purpose of the Study:
- To describe nutritional homeostasis in exclusively breastfed infants during the first five days of life.
- To investigate the relationship between infant nutrition and feeding behavior.
Main Methods:
- Cross-sectional measurements of body weight, blood glucose, plasma insulin, IGF-I, IGFBP-1, FFA, glycerol, ketone, and lactate.
- Timing of feeding intervals to assess feeding behavior.
Main Results:
- Infants experienced a maximal weight loss of 5.8% by day 2, with inhibited anabolic hormones and increased fat mobilization/ketogenesis.
- Feeding intervals shortened between days 1 and 2.
- Weight gain began by day 3, restoring fuel stores and anabolic status.
- Weight loss >10% led to starvation indicators and shorter feeding intervals.
Conclusions:
- Breastfeeding on demand supports nutritional balance, with increased feeding drive when weight loss is <6%.
- Significant weight loss (>10%) may trigger hunger due to reduced fuel availability.
Objectives And Methods:
Our goal was to describe nutritional homeostasis in healthy exclusively breastfed infants (n = 175) during their first 5 d, by cross-sectional measurements of body weight, blood glucose, plasma insulin, insulin-like growth factor-I (IGF-I), insulin-like growth factor binding-protein-1 (IGFBP-1), free fatty acids (FFA), glycerol, ketone (3-OH-butyric acid) and lactate. We also investigated whether nutrition affected feeding behaviour by timing the interval between feedings.
Results:
A progressive loss of body weight, as percentage of birthweight, occurred up to 2 d of age, with a maximal decrease of 5.8 +/- 2.1% (mean +/- SD); this was accompanied by inhibition of anabolic hormone and metabolic pathways and an increased mobilization of stored fat and ketogenesis. The interval between feedings decreased between d 1 and 2. Weight gain occurred at 3 d and the following re-feeding phase returned fuel stores to their previous levels and established an anabolic hormonal and metabolic situation. Infants with weight loss exceeding 10% had a further accentuation in their peripheral picture of starvation and a further 7% shortening of the interval between feedings.
Conclusions:
breastfeeding on demand is accompanied by a balanced nutritional situation and an increased drive to eat when weight reduction is <6%. However, a weight loss of > or = 10%, probably elicits hunger sensations in response to decreased fuel availability.