Gastric Acidity in the First Day of Life

Avery, Gordon B.; Randolph, Judson G.; Weaver, Thomas

doi:10.1542/peds.37.6.1005

Cited by 88 publications

(13 citation statements)

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“…Knowledge of age‐dependent changes in various physiological processes relevant to drug disposition from birth to adulthood, especially developmental trajectories of enzymes and transporters, has greatly expanded over the past 2 decades as summarized in a recent comprehensive review 169 . This new knowledge has led to an increasing number of new applications impacting regulatory and clinical decision‐making processes, such as initial dose selection for paediatric clinical trials, 170 extrapolation of a model developed for 1 compound to other compounds metabolized by the same elimination pathway, 171 potential for drug–drug interactions, 3,172 and paediatric regulatory approvals 173 . Particularly interesting are the use of population PK approaches to improve the quality of PBPK models 174 and the use of PBPK modelling and simulation to identify covariates that can be used to improve the quality of population PK models, 175 with further potential application for model‐informed precision dosing 176 .…”

Section: Discussion and Vision For The Futurementioning

confidence: 99%

“…The low pH environment of the stomach is favourable for the dissolution of weak bases, which constitute the majority of marketed drugs 2 . Amniotic fluid swallowed in utero results in a neutral gastric pH in children at birth, but the fasted pH of the stomach begins to decline thereafter 3 . While there is some debate over the exact timing, fasted gastric pH drops to values comparable to those seen in adults within the first few weeks of life 4–8 .…”

Section: Enteral Absorptionmentioning

confidence: 99%

“…2 Amniotic fluid swallowed in utero results in a neutral gastric pH in children at birth, but the fasted pH of the stomach begins to decline thereafter. 3 While there is some debate over the exact timing, fasted gastric pH drops to values comparable to those seen in adults within the first few weeks of life. [4][5][6][7][8] However, because pH can increase substantially in the postprandial period, timing of meals may be an even greater determinant of gastric pH in neonates than age-related alterations in basal hydrochloric acid secretion, 9,10 an important fact considering the frequency of feeding by neonates.…”

Section: Enteral Absorptionmentioning

confidence: 99%

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Recent advances in the ontogeny of drug disposition

Chapron

Leeder

2021

Brit J Clinical Pharma

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Developmental changes that occur throughout childhood have long been known to impact drug disposition. However, pharmacokinetic studies in the paediatric population have historically been limited due to ethical concerns arising from incorporating children into clinical trials. As such, much of the early work in the field of developmental pharmacology was reliant on difficult‐to‐interpret in vitro and in vivo animal studies. Over the last 2 decades, our understanding of the mechanistic processes underlying age‐related changes in drug disposition has advanced considerably. Progress has largely been driven by technological advances in mass spectrometry‐based methods for quantifying proteins implicated in drug disposition, and in silico tools that leverage these data to predict age‐related changes in pharmacokinetics. This review summarizes our current understanding of the impact of childhood development on drug disposition, particularly focusing on research of the past 20 years, but also highlighting select examples of earlier foundational research. Equally important to the studies reviewed herein are the areas that we cannot currently describe due to the lack of research evidence; these gaps provide a map of drug disposition pathways for which developmental trends still need to be characterized.

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Section: Discussion and Vision For The Futurementioning

confidence: 99%

Section: Enteral Absorptionmentioning

confidence: 99%

Section: Enteral Absorptionmentioning

confidence: 99%

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Recent advances in the ontogeny of drug disposition

Chapron

Leeder

2021

Brit J Clinical Pharma

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“…During childbirth, newborns may inhale (swallow) the vaginal contents in their mother’s birth canal ( Butler É et al., 2020 ). The stomachs of newborns are pH neutral for several hours post birth as a result of swallowing the amniotic fluid in utero , thereby enabling the survival of ingested bacteria ( Avery et al., 1966 ). However, the exposure application in our work deliberately avoided contact with the CS newborns’ oral cavity, which might eliminate microbial colonization via the oral transmission route.…”

Section: Discussionmentioning

confidence: 99%

Maternal vaginal fluids play a major role in the colonization of the neonatal intestinal microbiota

Xie

Tang

Hong

et al. 2023

Front. Cell. Infect. Microbiol.

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BackgroundCaesarean section (CS) is associated with newborns’ health risks due to the blocking of microbiome transfer. The gut microbiota of CS-born babies was different from those born vaginally, which may be attributed to reduced exposure to maternal vaginal microbes during labour. To understand the microbial transfer and reduce CS disadvantages, the effect of vaginal microbiota exposure on infant gut microbiota composition was evaluated using 16s rDNA sequencing-based techniques.ResultsPregnant women were recruited in the Women and Children’s Hospital, School of Medicine, Xiamen University from June 1st to August 15th, 2017. Maternal faeces (n = 26), maternal vaginal fluids (n = 26), and neonatal transitional stools (n = 26) were collected, while the participants underwent natural delivery (ND) (n = 6), CS (n = 4) and CS with the intervention of vaginal seedings (I) (n = 16). 26 mothers with the median age 26.50 (25.00-27.25) years showed no substantial clinical differences. The newborns’ gut microbiota altered among ND, CS and I, and clustered into two groups (PERMANOVA P = 0.001). Microbial composition of ND babies shared more features with maternal vaginal samples (PERMANOVA P = 0.065), while the microbiota structure of ND babies was obviously different from that of sample of maternal faeces. The genus Bacteroides in CS-born babies with intervention approached to vaginal-born neonates, compared with CS-born neonates without intervention.ConclusionsNeonatal gut microbiota was dependent on the delivery mode. And the gut microbiota CS newborns with vaginal seeding shared more features with those of ND babies, which hinted the aberrant gut microbiota composition initiated by CS might be partly mitigated by maternal vaginal microbiota exposure.

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“…During childbirth, newborns may inhale (swallow) the vaginal contents in their mother's birth canal [30]. The stomachs of newborns are pH neutral for several hours post birth as a result of swallowing the amniotic uid in utero, thereby enabling the survival of ingested bacteria [31].…”

Section: Discussionmentioning

confidence: 99%

Maternal Vaginal Fluids Play A Major Role In The Colonization of The Neonatal Intestinal Microbiota

Tang

Zhang

Xie

et al. 2021

Preprint

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Background: Caesarean delivery (CD) is associated with newborns’ health risks due to the blocking of microbiome transfer. To understand the vertical bacterial seeding and reduce CD disadvantages, microbiome transmissions via anal and genital routes were investigated, and the efficiency of vaginal fluid swabbing treatment was evaluated using 16s rDNA sequencing-based techniques.Results: Pregnant women were recruited in the Women and Children’s Hospital, School of Medicine, Xiamen University from June 1st to August 15th, 2017. Maternal faeces (n = 26), maternal vaginal fluids (n = 26), and neonatal transitional stools (n = 26) were collected, while the participants underwent natural delivery (ND) (n = 6), CD (n = 4) and CD with vaginal fluid swabbing (CS) on their newborns (n = 16). 26 mothers with the median age 26.50 (25.00-27.25) years showed no substantial clinical differences. The newborns’ gut microbiota altered among ND, CD and CS, and clustered into two groups (PERMANOVA P < 0.01) of swabbing and no-swabbing exposure. Gut colonization of ND babies majorly originated from maternal vaginal microbes (PERMANOVA P = 0.08), no vertical transmission was observed via anal route in any group. The vaginal transfer partially occurred by swabbing, in which the phyla Firmicutes and Proteobacteria and the genera Lactobacillus, Bacteroides, and Escherichia-Shigella in newborns were similar to their mothers. The recovered taxa predicted KEGG functions of biosynthesis, metabolism, and DNA replication and repair with benefits of low risks of digestive, cardiovascular, and immune diseases.Conclusions: The newborn’s gut microbiota is mainly shaped by maternal vaginal microbiota, and aberrant colonization initiated by CD is partly mitigated by the swabbing treatment.

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Gastric Acidity in the First Day of Life

Cited by 88 publications

References 0 publications

Recent advances in the ontogeny of drug disposition

Recent advances in the ontogeny of drug disposition

Maternal vaginal fluids play a major role in the colonization of the neonatal intestinal microbiota

Maternal Vaginal Fluids Play A Major Role In The Colonization of The Neonatal Intestinal Microbiota

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