Article Text

Download PDFPDF
Minimal enteral feeding, fetal blood flow pulsatility, and postnatal intestinal permeability in preterm infants with intrauterine growth retardation
  1. R M van Elburg1,
  2. A van den Berg1,
  3. C M Bunkers2,
  4. R A van Lingen2,
  5. E W A Smink2,
  6. J van Eyck3,
  7. W P F Fetter1
  1. 1Department of Paediatrics, Division of Neonatology, VU University Medical Centre, Amsterdam, the Netherlands
  2. 2Department of Paediatrics, Division of Neonatology, Isala Clinics location Sophia, Zwolle, the Netherlands
  3. 3Department of Obstetrics, Isala Clinics location Sophia, Zwolle, the Netherlands
  1. Correspondence to:
    Dr van Elburg
    Department of Paediatrics, Division of Neonatology, VU University Medical Centre, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands; rm.vanelburgvumc.nl

Abstract

Objective: To study the effect of minimal enteral feeding (MEF) on intestinal permeability and feeding tolerance in preterm infants with intrauterine growth retardation (gestational age < 37 weeks, birth weight for gestational age p < 10). Furthermore, to determine whether fetal blood flow pulsatility or intestinal permeability predict feeding tolerance in these infants.

Design: Randomised controlled trial.

Methods: Within 48 hours of birth, infants were randomised to MEF or no enteral feeding (NEF) for five days in addition to parenteral feeding. Intestinal permeability was measured by the sugar absorption test before (SAT1) and after (SAT2) the study. The sugar absorption test measured the urinary lactulose/mannitol (LM) ratio after oral ingestion of a solution (375 mosm) containing mannitol and lactulose. Charts of all infants were assessed for measures of feeding tolerance. Fetal blood flow pulsatility index (U/C ratio) was measured within the seven days before birth.

Results: Of the 56 infants enrolled, 42 completed the study: 20 received MEF and 22 NEF. The decrease in LM ratio (LM ratio 1 − LM ratio 2) was not significantly different between the two groups (0.25 v 0.11; p  =  0.14). Feeding tolerance, growth, and incidence of necrotising enterocolitis were not significantly different between the two groups. Neither the U/C nor the LM ratio 1 predicted feeding tolerance.

Conclusions: The results suggest that MEF of preterm infants with intrauterine growth retardation has no effect on the decrease in intestinal permeability after birth. Neither fetal blood flow pulsatility nor intestinal permeability predicts feeding tolerance.

  • MEF, minimal enteral feeding
  • NEC, necrotising enterocolitis
  • NEF, no enteral feeding
  • PI, pulsatility index
  • SAT, sugar absorption test
  • IUGR, intrauterine growth retardation
  • fetal blood flow pulsatility
  • intestinal permeability
  • fetal growth retardation
  • preterm infant
  • enteral nutrition

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

Linked Articles

  • Fantoms
    Martin Ward Platt