Skip to main content
SpringerLink
Log in

Fat absorption in premature infants: The effect of lard and antibiotics

  • Nutrition
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Fat absorption of an adapted cow's milk formula was studied in a randomized controlled trial involving two groups of 18 premature infants (mean gestational age±SD: 33.0±2.9 weeks, range 26.5–37.5 weeks). The triglyceride configuration was modified by the use of lard. This modification did not improve the absorption of fat or energy. Also no difference in serum concentrations of cholesterol and tridifference was found. Growth velocity during the study was similar in both groups. Detailed analysis of the data revealed that in infants who received (parenterally) antibiotics (mainly ampicillin and netilmicin) a higher coefficient of fat absorption (+20%,P<0.01) and of energy absorption (+8%,P=0.03) was found. Based on these results, we find no support for the use of lard in adapted cow's milk infant formulas to improve fat absorption. In studies of fat and energy absorption the effects of antibiotics have to be taken into account.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

Almiron AB-L:

lard modified infant formula

Almiron AB:

low lactose infant formula

References

  1. Alemi B, Hamosh M, Scanlon JW, Salzman-Mann C, Hamosh P (1981) Fat digestion in very-low-birth-weight infants: effects of addition of human milk to low-birth-weight formula. Pediatrics 68: 484–489

    PubMed  Google Scholar 

  2. Apstein MD, Russo AR (1985) Ampicillin inhibits biliary cholesterol secretion. Dig Dis Sci 30:253–256

    PubMed  Google Scholar 

  3. Atkinson SA, Bryan MH, Anderson H (1981) Human milk feeding in premature infants: protein, fat, and carbohydrate balances in the first two weeks of life. J Pediatr 99:617–624

    PubMed  Google Scholar 

  4. Bach AC, Babayan VK (1982) Medium-chain triglycerides: an update. Am J Clin Nutr 36:950–962

    PubMed  Google Scholar 

  5. Brooke OG (1985) Absorption of lard by infants. Hum Nutr Appl Nutr 39A:221–223

    Google Scholar 

  6. Brooke OG, Wood C, Barley J (1982) Energy balance, nitrogen balance, and growth in preterm infants fed expressed breast milk, a premature infant formula, and two low-solute adapted formulas. Arch Dis Child 57:898–904

    PubMed  Google Scholar 

  7. Carulli N, Ponz de Leon M, Loria P, Iori R, Rosi A, Romani M (1981) Effect of selective expansion of cholic acid pool on bile lipid composition: possible mechanism of bile acid induced biliary cholesterol desaturation. Gastroenterology 81:539–546

    PubMed  Google Scholar 

  8. Chappell JE, Clandinin MT, Kearny-Volpe C, Reichman B, Swyer PW (1986) Fatty acid balance studies in premature infants fed human milk or formula: effect of calcium supplementation. J Pediatr 108:439–447

    PubMed  Google Scholar 

  9. Edginton ES (1980) Randomization tests. Dekker, New York

    Google Scholar 

  10. Filer LJ, Mattson FH, Fomon SJ (1969) Triglyceride configuration and fat absorption by the human infant. J Nutr 99:293–298

    PubMed  Google Scholar 

  11. Finley AJ, Davidson M (1980) Bile acid excretion and patterns of fatty acid absorption in formula-fed premature infants. Pediatrics 65:132–138

    PubMed  Google Scholar 

  12. Harries JT (1982) Fat absorption in the newborn. Acta Paediatr Scand [Suppl] 299:17–23

    Google Scholar 

  13. Hernell O, Blackberg L (1983) Bile-salt-stimulated lipase of human milk and lipid digestion in the neonatal period. J Pediatr Gastroenterol Nutr 2[Suppl 1]:S242-S247

    PubMed  Google Scholar 

  14. ISO 6800-1985 (1985) Animal and vegetable fats and oils. Determination of the composition of fatty acids in the 2-position. Ed. 1.5 p. Geneve

  15. James Smith-Behn J, Ghani A (1987) Biliary excretion of ampicillin, cefamandole, and cefuroxime in dogs. Curr Ther Res 42:44–47

    Google Scholar 

  16. Järvenpää AL (1983) Feeding the low-birth-weight infant IV. Fat absorption as a function of diet and duodenal bile acids. Pediatrics 72:684–689

    PubMed  Google Scholar 

  17. Jensen C, Buist NRM, Wilson T (1986) Absorption of individual fatty acids from long chain or medium chain triglycerides in very small infants. Am J Clin Nutr 43:745–751

    PubMed  Google Scholar 

  18. Kamer JH van de, Bokkel Huinink H ten, Weijers HA (1949) Rapid method for the determination of fat in the faeces. J Biol Chem 177:347–355

    Google Scholar 

  19. Kocoshis SA, Schletewitz K, Lovelace G, Laine RA (1987) Duodenal bile acids among children: keto derivatives and aerobic small bowel bacterial overgrowth. J Pediatr Gastroenterol Nutr 6:686–696

    PubMed  Google Scholar 

  20. Lavy U, Silverberg M, Davidson M (1971) Role of bile acids in fat absorption in low birth weight infants. Pediatr Res 5:387A

    Google Scholar 

  21. Lebenthal E, Lee PC (1980) Development of functional response in human exocrine pancreas. Pediatrics 66:556–560

    PubMed  Google Scholar 

  22. Midtvedt T (1974) Microbial bile acid transformation. Am J Clin Nutr 27:1341–1347

    PubMed  Google Scholar 

  23. Miller DS, Payne PR (1959) A ballistic bomb calorimeter. Br J Nutr 13:501–508

    PubMed  Google Scholar 

  24. Norman A, Strandvik B, Ojamae O (1972) Bile acids and pancreatic enzymes during absorption in the newborn. Acta Paediatr Scand 61:571–576

    PubMed  Google Scholar 

  25. Okamoto E, Muttart CR, Zucker CL, Heird WC (1982) Use of medium-chain triglycerides in feeding the low-birth-weight infant. Am J Dis Child 136:428–431

    PubMed  Google Scholar 

  26. Putet G, Senterre J, Rigo J, Salle B (1984) Nutrient balance, energy utilization, and composition of weight gain in very-low-birth-weight infants fed pooled human milk or a preterm formulae. J Pediatr 105:79–85

    PubMed  Google Scholar 

  27. Rao SSC, Edwards CA, Austen CJ, Bruce C, Read NW (1988) Impaired colonic fermentation of carbohydrate after ampicillin. Gastroenterology 94:928–932

    PubMed  Google Scholar 

  28. Rey J, Schmitz J, Amedee-Manasme O (1982) Fat absorption in low birthweight infants. Acta Paediatr Scand [Suppl] 296:81–84

    Google Scholar 

  29. Roy CC, Ste-Marie M, Chartrand L, Weber A, Bard H, Doray B (1975) Correction of the malabsorption of the preterm infant with a medium-chain triglyceride formula. J Pediatr 86:446–450

    PubMed  Google Scholar 

  30. Sarda P, Lepage G, Roy CC, Chessex Ph (1987) Storage of medium-chain triglycerides in adipose tissue of orally fed infants. Am J Clin Nutr 45:399–405

    PubMed  Google Scholar 

  31. Saxerholt H, Carlstedt-Duke B, Hoverstad T, Lingaas E, Norin KE, Steinbakk M, Midtveldt T (1986) Influence of antibiotics on the fecal excretion of bile pigments in healthy subjects. Scand J Gastroenterol 21:991–996

    PubMed  Google Scholar 

  32. Schanler RJ, Garza C, Nichols BL (1985) Fortified mothers milk for very low birth weight infants: results of growth and nutrient balance studied. J Pediatr 107:437–445

    PubMed  Google Scholar 

  33. Signer E, Murphy GM, Edkins S, Anderson CM (1974) Role of bile salts in fat malabsorption of premature infants. Arch Dis Child 49:174–180

    PubMed  Google Scholar 

  34. Somer P de, Eyssen H, Evrard E (1963) The influence of antibiotics on fecal fat in chicks. In: Frazer AC (ed) Biochemical problems of lipids. Elsevier, Amsterdam, pp 84–90

    Google Scholar 

  35. Tantibhedhyangkul P, Hashim SA (1975) Medium-chain triglyceride feeding in premature infants: effects on fat and nitrogen absorption. Pediatrics 55:359–370

    PubMed  Google Scholar 

  36. Tomarelli RM, Meyer BJ, Weaber JR, Bernhart FW (1968) Effect of positional distribution on the absorption of the fatty acids of human milk and infant formulas. J Nutr 95:583–590

    PubMed  Google Scholar 

  37. Watkins JB (1975) Mechanisms of fat absorption and the development of gastrointestinal function. Pediatr Clin North Am 22:721–730

    PubMed  Google Scholar 

  38. Watkins JB, Lester R, Bliss CM, Donaldson RM (1972) Characterization of newborn fecal lipid. Pediatr Res 6:375A

    Google Scholar 

  39. Watkins JB, Järvenpää AL, Szczepanik-van Leeuwen P, Klein P, Rassin DK, Gaull G, Räihä NCR (1983) Feeding the low birth weight infant: effects of taurine, cholesterol, and human milk on bile acid kinetics. Gastroenterology 85:793–800

    PubMed  Google Scholar 

  40. Zoppi G, Andreotti G, Njai DM, Gaburro D (1972) Exocrine pancreas function in premature and full term neonates. Pediatr Res 6:880–886

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Paediatrics, University Hospital Groningen, Oostersingel 59, 9713 EZ, Groningen, The Netherlands

    H. J. Verkade, W. A. van Asselt, R. J. Vonk, C. M. A. Bijleveld, F. Fernandes, H. de Jong & A. Okken

  2. Department of Medical Statistics, University Hospital Groningen, Oostersingel 59, 9713 EZ, Groningen, The Netherlands

    V. Fidler

Authors
  1. H. J. Verkade
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. A. van Asselt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. J. Vonk
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. M. A. Bijleveld
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Fernandes
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. H. de Jong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. V. Fidler
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Okken
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Verkade, H.J., van Asselt, W.A., Vonk, R.J. et al. Fat absorption in premature infants: The effect of lard and antibiotics. Eur J Pediatr 149, 126–129 (1989). https://doi.org/10.1007/BF01995863

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01995863

Key Words

Search

Navigation