Stool and urinary sugars in normal neonates.

Abstract

. Stool and urinary sugars in normal neonates. The pH of the stool and the amount of reducing substances present were observed in 51 normal neonates aged 5 to 8 days. A stool pH of 5 or less was found in 6, 4 of whom were exclusively breast fed. Reducing substances, 0 5 % or more, were found in the stools of 16. Stool chromatography in 13 showed lactose, glucose, galactose, or a variable combination of these sugars-that is, a pattern consistent with lactose malabsorption. The stools of 3 infants contained oligosaccharides or maltose only.Chromatography of urine from 60 normal neonates showed detectable sugars in 11 but only 3 had levels above 50 mg/100 ml.Reports on the sugar content of the stools and urine of normal neonates are conflicting, though in older children more than 0 5% of reducing substances in the stools or more than 15 mg/100 ml in the urine are generally agreed to be abnormal (Kerry and Anderson, 1964;Menzies and Seakins, 1969). Davidson and Mullinger (1970) Bickel (1961), studying 155 specimens of urine from 88 normal neonates, found the mean 'normal' lactose to be between 20 mg/100 ml and 50 mg/100 ml between the third and seventh day of life. Haworth and McCredie (1956) found that about half of 50 normal breast-fed babies had reducing sugars in their urine at some time during the first weeks of life and a substantial minority had more than 50 mg/100 ml, yet more than 15 mg/100 ml of sugar in the urine of neonates who have had surgery has been regarded by some workers as confirming a diagnosis of sugar intolerance (Howat and Aaronson, 1971 urine sugar levels in normal breast-and bottle-fed newborn infants. This paper reports the results.Patients and methods Specimens of stool or urine, or both, were obtained from 73 infants in the lying-in wards of the Mother's Salvation Army Hospital, Clapton. At the time of collection 53 of the infants were 5 days old, 17 were 6 days old, 2 were 4 days old, and 1 was 8 days old. Stools alone were collected from 13 infants, urine alone from 22 and both stools and urine from 38. Their birth weight ranged from 2 -3 to 4 -2 kg (mean 3 * 19 kg) and their gestation from 35 weeks to 42 weeks (mean 38 -1 weeks).Feeds were classified as breast, bottle (in all cases prepacked half cream Cow and Gate), and mixedthat is, breast-fed plus complements of half cream Cow and Gate. This formula contains 7-1 g lactose/100 ml but no sucrose.Urine was collected at random times into U-bags (Hollister) and then deep-frozen in plastic bottles.Stools were collected on the same day into a nappy lined with plastic and were stored in plastic containers in a deep-freeze within 2 hours, in most cases. There was no absolute certainty that stools were not contaminaed by urine, although every endeavour was made to avoid this. The converse could easily be seen on inspection of the urine container at the time of testing and any faecally contaminated specimen was discarded.After thawing, stool and urine specimens were first tested for reducing substances with Clinitest tablets (Kerry and Anders...

Faecal excretion of oligosaccharides and other carbohydrates in normal neonates.

“…The infant (Case 1) was put on a lactose-free diet consisting of Galactomin 17, which does not contain oligosaccharide I, and the oligosaccharide I disappeared from the stool. This would seem to confirm the dietary origin of the oligosaccharide, and we do not agree with Counahan and Walker-Smith (1976) that stool oligosaccharides are rarely found and are primarily of bacterial origin. As fucose and glucose were seen only in the presence of galactose, it is likely that these 3 sugars are the products of the intestinal hydrolysis of fucosyl lactose as they were also found on acid hydrolysis of a stool containing oligosaccharide I.…”

“…Our findings confirm those of previous workers who have shown the frequent presence of large amounts of reducing substances in the stools of infants in the first week of life, particularly in babies who are breast fed (Davidson and Mullinger, 1970;Counahan and Walker-Smith, 1976). All but two samples had a pH < 6, and we would not recommend that stools from infants in this age group be examined for the presence of reducing substances or pH as a screening test for carbohydrate malabsorption.…”

Lactose in Human Breast Milk an Inducer of Innate Immunity with Implications for a Role in Intestinal Homeostasis

“…Our results demonstrate no detectable levels of lactose in fecal samples of both one and four week old infants (Table 1). This suggest an efficient hydrolysis of lactose in the small bowel, which is in agreement with previous reports [33]. Hoerver, we cannot rule out the possibility that a part of the lactose is internalized by the colonic epithelial cells.…”

Lactose intolerance and gastrointestinal cow’s milk allergy in infants and children – common misconceptions revisited

“…Up to 0.25% of total/reducing sugars is considered normal. In young breastfed infants with physiological lactose malabsorption, concentrations may be higher [ 54 ]. The test is not recommended in children older than 2 years of age due to a righ rate of false-negative results.…”