Gavage Feed Volume Determines the Gastric Emptying Rate in Preterm Infants

Ferreira, Cristina Helena Faleiros; Martinez, Francisco Eulógio; Crott, Gerson Cláudio; Belik, Jaques

doi:10.1097/mpg.0000000000001985

Cited by 6 publications

(3 citation statements)

References 23 publications

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“…In addition, the newborn rat’s gastric milk emptying rate is directly proportional to the stomach’s curd volume[ 5 ]. We further documented that a similar positive correlation between gastric milk volume and its emptying rate is present in preterm neonates[ 14 ].…”

Section: Discussionmentioning

confidence: 83%

Adiponectin and the regulation of gastric content volume in the newborn rat

Wang¹,

Esemu-Ezewu²,

Pan³

et al. 2021

WJG

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BACKGROUND Oral intake is dependent on the gastric ability to accommodate the food bolus. Comparatively, neonates have a smaller gastric capacity than adults and this may limit the volume of their milk intake. Yet, we previously reported that the newborn rat gastric milk volume is greatest after birth and, when normalized to body weight, decreases with postnatal age. Such age-dependent changes are not the result of intake differences, but greater gastric accommodation and reduced emptying rate. AIM Hypothesizing that breastmilk-derived adiponectin is the factor regulating gastric accommodation in neonates, we comparatively evaluated its effects on the rat fundic muscle tone at different postnatal ages. METHODS In freshly dispersed smooth muscle cells (SMC), we measured the adiponectin effect on the carbachol-induced length changes. RESULTS Adiponectin significantly reduced the carbachol-stimulated SMC shortening independently of age. In the presence of the inhibitor iberiotoxin, the adiponectin effect on SMC shortening was suppressed, suggesting that it is mediated via large-conductance Ca 2+ sensitive K + channel activation. Lastly, we comparatively measured the newborn rat gastric milk curd adiponectin content in one- and two-week-old rats and found a 50% lower value in the latter. CONCLUSION Adiponectin, a major component of breastmilk, downregulates fundic smooth muscle contraction potential, thus facilitating gastric volume accommodation. This rodent’s adaptive response maximizes breastmilk intake volume after birth.

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Section: Discussionmentioning

confidence: 83%

Adiponectin and the regulation of gastric content volume in the newborn rat

Wang¹,

Esemu-Ezewu²,

Pan³

et al. 2021

WJG

Self Cite

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“…Withholding of enteral feeding or cessation of advancement in the amounts given due to misinterpretation of routine gastric aspirates may have a negative impact on the preterm neonate. This can potentially involve prolonged indwelling of venous catheters, a higher risk of infection and growth restriction with potentially worse developmental outcomes for very low birth weight infants (Ferreira, Martinez, Crott, & Belik, 2018).…”

Section: Significance Of the Studymentioning

confidence: 99%

Effect of non-aspirated gastric residual content on preterm infants' health status

Ramadan

Rashad

Darwish

et al. 2022

ijhs

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Background: Gastric residuals (GR) aspiration is considered standard practice for preterm infants in the neonatal intensive care unit (NICU). Unfortunately, there is little information about the dangers and advantages of this routine procedure. Various care procedures, such as the measurement of gastric residual volume (GRV), may contribute to the problem of inadequate calorie intake in preterm newborns. Aim: The current study aimed to evaluate the effect of non-gastric residual aspiration on preterm infant weight, necrotizing enterocolitis, and time to reach full enteral feeding. Methods: A quasi-experimental (control and intervention) design was used in the study. El-Manial University Hospital and Elmonira Pediatric Hospital NICUS cared for sixty preterm infants. Four different tools were used: (I) Neonatal personal information; (II) a gastric residual observational checklist; (III) the Fenton Growth Weight Chart; and (IV) Modified Bell's Staging Criteria for Necrotizing Enterocolitis. The results: The mean number of days required to achieve full enteral intake of 120 ml kg per day in the intervention group was 7.21 ± 0.66, whereas, in the control group, it was 9.72 ± 0.85, a difference that was slightly significant at the p-value < 0.05.

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“…For sensitive pediatric patients, too much BC-derived casein may adversely affect GI motility and delay gastric emptying due to casein clotting in the stomach. Thus, casein-based pediatric formulas often consist of partly hydrolyzed proteins [ 303 , 304 ] to avoid feeding intolerance, gastric residuals, and constipation, as often observed in preterm infants [ 305 , 306 , 307 ]. Low-dose BC supplementation within normal protein limits of preterm infants is unlikely to induce casein-related dysmotility and ongoing clinical trials will test this [ 154 , 209 , 224 ].…”

Section: Possible Health Risks Of Using Bovine Colostrum In Pediatricsmentioning

confidence: 99%

Potential Benefits of Bovine Colostrum in Pediatric Nutrition and Health

et al. 2021

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Bovine colostrum (BC), the first milk produced from cows after parturition, is increasingly used as a nutritional supplement to promote gut function and health in other species, including humans. The high levels of whey and casein proteins, immunoglobulins (Igs), and other milk bioactives in BC are adapted to meet the needs of newborn calves. However, BC supplementation may improve health outcomes across other species, especially when immune and gut functions are immature in early life. We provide a review of BC composition and its effects in infants and children in health and selected diseases (diarrhea, infection, growth-failure, preterm birth, necrotizing enterocolitis (NEC), short-bowel syndrome, and mucositis). Human trials and animal studies (mainly in piglets) are reviewed to assess the scientific evidence of whether BC is a safe and effective antimicrobial and immunomodulatory nutritional supplement that reduces clinical complications related to preterm birth, infections, and gut disorders. Studies in infants and animals suggest that BC should be supplemented at an optimal age, time, and level to be both safe and effective. Exclusive BC feeding is not recommended for infants because of nutritional imbalances relative to human milk. On the other hand, adverse effects, including allergies and intolerance, appear unlikely when BC is provided as a supplement within normal nutrition guidelines for infants and children. Larger clinical trials in infant populations are needed to provide more evidence of health benefits when patients are supplemented with BC in addition to human milk or formula. Igs and other bioactive factors in BC may work in synergy, making it critical to preserve bioactivity with gentle processing and pasteurization methods. BC has the potential to become a safe and effective nutritional supplement for several pediatric subpopulations.

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Gavage Feed Volume Determines the Gastric Emptying Rate in Preterm Infants

Cited by 6 publications

References 23 publications

Adiponectin and the regulation of gastric content volume in the newborn rat

Adiponectin and the regulation of gastric content volume in the newborn rat

Effect of non-aspirated gastric residual content on preterm infants' health status

Potential Benefits of Bovine Colostrum in Pediatric Nutrition and Health

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