Nutritional management of newborn infants: Practical guidelines

Xiao-ming, Ben

doi:10.3748/wjg.14.6133

Cited by 59 publications

(56 citation statements)

References 18 publications

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“…On day 5, the PN was discontinued and all piglets were given increasing amounts of raw bovine milk (64 -150 ml·kg Ϫ1 ·day Ϫ1 ) to day 9 and subsequently transferred to reconstituted whole milk powder at 150 -200 ml·kg Ϫ1 ·day Ϫ1 (Arla Foods Ingredients, Viby, Denmark) until day 26. The dosing strategies for both TPN and enteral feeding are comparable with the feeding advancement rates used for moderately preterm infants (4,13,17,25,53). See Fig.…”

Section: Animals and Nutritionmentioning

confidence: 79%

Rapid gut growth but persistent delay in digestive function in the postnatal period of preterm pigs

Hansen

Thymann

Andersen

et al. 2016

American Journal of Physiology-Gastrointestinal and Liver Physi

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Preterm infants often tolerate full enteral nutrition a few weeks after birth but it is not known how this is related to gut maturation. Using pigs as models, we hypothesized that intestinal structure and digestive function are similar in preterm and term individuals at 3-4 wk after birth and that early enteral nutrition promotes maturation. Preterm or term cesareandelivered pigs were fed total parenteral nutrition, or partial enteral nutrition [Enteral (Ent), 16 -64 ml·kg Ϫ1 ·day Ϫ1 of bovine colostrum] for 5 days, followed by full enteral milk feeding until day 26. The intestine was collected for histological and biochemical analyses at days 0, 5, and 26 (n ϭ 8 -12 in each of 10 treatment groups). Intestinal weight (relative to body weight) was reduced in preterm pigs at 0 -5 days but ENT feeding stimulated the mucosal volume and peptidase activities. Relative to term pigs, mucosal volume remained reduced in preterm pigs until 26 days although plasma glucagon-like peptide 2 (GLP-2) and glucose-dependent insulin-trophic peptide (GIP) levels were increased. Preterm pigs also showed reduced hexose absorptive capacity and brush-border enzyme (sucrase, maltase) activities at 26 days, relative to term pigs. Intestinal structure shows a remarkable growth adaptation in the first week after preterm birth, especially with enteral nutrition, whereas some digestive functions remain immature until at least 3-4 wk. It is important to identify feeding regimens that stimulate intestinal maturation in the postnatal period of preterm infants because some intestinal functions may show long-term developmental delay. prematurity; gut development; enzymes; digestion; glucagon-like peptide 2 ABOUT 10% OF ALL INFANTS are born preterm (Ͻ37 weeks of gestation) and the proportion is increasing in most countries (6). Preterm infants show an increased susceptibility to infections, respiratory distress syndrome, intracranial hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity, extrauterine growth restriction, neurodevelopmental disturbances, and necrotizing enterocolitis (NEC) (21, 31). The challenges are inversely related to gestational age at birth and the most severe adaptation problems occur during the first few weeks after birth. If preterm infants survive the difficult neonatal period, their body functions often adapt well, although some organ systems may show long-term developmental delay or deficits (18). It remains unknown how different organ systems adapt in preterm infants and when parameters of structure and function become similar to those in term infants. For gastrointestinal (GI) functions, eating disorders and dysregulated appetite have been reported in preterm infants (44) but very little is known about the long-term adaptation of the GI tract in preterm neonates.Investigations of postnatal GI adaptation in preterm neonates are difficult without an animal model that combines preterm birth, high NEC risk, and clinically relevant feeding interventions, such as parenteral and enteral nutrition. Piglets delivere...

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Section: Animals and Nutritionmentioning

confidence: 79%

Rapid gut growth but persistent delay in digestive function in the postnatal period of preterm pigs

Hansen

Thymann

Andersen

et al. 2016

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…VA doses are more efficacious when given as a lipid bolus, in addition to that which is delivered in milk. 37 However, young infants may not be able to absorb these doses as efficiently as older children, 38 and very LBW infants need special nutritional management. 37 The percentage of dose found in extrahepatic organs did not differ between treatment or time groups, similar to VA concentration.…”

Section: Discussionmentioning

confidence: 99%

“…37 However, young infants may not be able to absorb these doses as efficiently as older children, 38 and very LBW infants need special nutritional management. 37 The percentage of dose found in extrahepatic organs did not differ between treatment or time groups, similar to VA concentration. The higher recovery in the piglets that were killed at 24 vs. 12 h likely reflects more uptake of the VA dose during subsequent meals.…”

Section: Discussionmentioning

confidence: 99%

Healthy birth weight results in higher vitamin A storage in neonate piglets administered high-dose supplements

Heying

Hovel

Tanumihardjo

2015

Exp Biol Med (Maywood)

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A proposed intervention for newborn infants in countries with suspected vitamin A (VA) deficiency is to administer 50,000 IU retinyl palmitate at birth to reduce mortality risk. However, no studies have investigated birth weight effects. In this study, low birth weight (LBW; <1 kg, n ¼ 18) and healthy birth weight (HBW) piglets (>1.5 kg, n ¼ 18) from VA-depleted sows were dosed with 25,000 or 50,000 IU retinyl palmitate (26.2 or 52.4 mmol retinol equivalents) at birth to compare VA reserves. Blood was collected at varying times (n ¼ 3-5/time/dose), and piglets were killed at 12 or 24 h for blood, liver, kidneys, spleen, lungs, adrenal gland, and intestinal contents. HBW piglets had significantly higher birth, death, and organ weights than LBW (P < 0.0001 for all). HBW and LBW piglets, which received VA, had higher liver and kidney VA concentrations (0.18 AE 0.09, 0.24 AE 0.10 mmol/g liver and 13.4 AE 4.1, 14.2 AE 4.5 nmol/g kidney, respectively) than controls (n ¼ 10) (0.051 AE 0.01 mmol/g liver and 1.01 AE 0.43 nmol/g kidney) (P ¼ 0.0061 and < 0.0001, respectively). Total liver (9.75 AE 5.16 mmol) and kidney retinol (204 AE 79.1 nmol) were higher in HBW than LBW piglets (P < 0.0001). Extrahepatic tissues, except lung, had higher VA concentration than controls (P < 0.0001). Serum retinol and ester concentrations were higher in treated than control piglets (P ¼ 0.0028, P < 0.0001, respectively), and significantly changed during the times sampled (P ¼ 0.022, P ¼ 0.011, respectively). Peak serum retinyl ester concentrations, which occurred at 3 h, were higher in piglets that received 50,000 IU (4.2 AE 4.4 mmol/L) than 25,000 IU (2.7 AE 2.3 mmol/L) (P ¼ 0.031). Regardless of dose amount, HBW piglets stored more supplemental VA than LBW piglets when administered at birth.

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“…The use of birth weight classifications as an exposure factor across studies was perhaps the most important limitation, because not all of the studies adjusted the subjects' birth weight for GA. For that reason, some of the studies included preterm newborn infants. This feature might indicate the presence of selection bias (Cresswell et al 1997, Michelmore et al 2001, Sadrzadeh et al 2003, Ibáñ ez et al 2008, Legro et al 2010, Hizli et al 2012, Mumm et al 2013, Shayeb et al 2014, especially considering that the functional maturation of organs and tissues of a preterm newborn is completed during postnatal life (Ben 2008).…”

Section: Genetic Predispositionmentioning

confidence: 99%

Pathogenesis of polycystic ovary syndrome: multifactorial assessment from the foetal stage to menopause

Melo¹,

Dias²,

Cavalli³

et al. 2015

Reproduction

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Polycystic ovary syndrome (PCOS) is a multifactorial disorder that arises from interactions between genetic, environmental and intrauterine factors. Small-for-gestational-age (SGA) babies and the daughters of mothers with PCOS represent possible postnatal clinical targets for developmental programming by steroid excess. The presence of excess glucocorticoids and/or androgens during foetal organogenesis and growth might promote changes in gene expression, and these changes might be related to an increase in the risk of PCOS-like reproductive and metabolic disorders in postnatal life, such as rapid growth and weight gain during the first 2 years of life (only in SGA babies), hyperinsulinaemia, adipocyte dysfunction and childhood visceral obesity, premature pubarche and adrenarche (only in SGA babies) and PCOS. In the fourth decade of life, women who have PCOS may be at higher risk for type 2 diabetes mellitus, dyslipidaemia and systemic arterial hypertension, which suggests that these women are also at higher risk for cardiovascular disease during menopause. However, PCOS can also occur in women who were born at appropriate weight for GA or in newborns of women without PCOS, which suggests that genetic variation and environmental factors play important roles in the development and maintenance of PCOS in a population. Genome-wide association studies based on adequate population samples have shown a higher frequency of genetic polymorphisms of the LHCGR, THADA and DENND1A genes in women with PCOS. Genetic studies of PCOS have also included analyses of structural changes in the chromosome based on an assessment of telomere length in single, cross-sectional evaluations, and these studies have produced controversial results. The present narrative review assesses the multifactorial origins of PCOS (including environmental, genetic and intra-uterine factors) and the development of conditions associated with this disorder. It is concluded that although PCOS might originate in the intra-uterine environment through developmental programming by steroid excess, the interaction between genetic and environmental factors is crucial for its appearance. Follow-up studies should be conducted to assess the same populations over their entire lifespans while taking into account different aspects of the pathogenesis of PCOS.Reproduction (2015) 150 R11-R24

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Nutritional management of newborn infants: Practical guidelines

Cited by 59 publications

References 18 publications

Rapid gut growth but persistent delay in digestive function in the postnatal period of preterm pigs

Rapid gut growth but persistent delay in digestive function in the postnatal period of preterm pigs

Healthy birth weight results in higher vitamin A storage in neonate piglets administered high-dose supplements

Pathogenesis of polycystic ovary syndrome: multifactorial assessment from the foetal stage to menopause

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