Skip to main content
SpringerLink
Log in

Neonatal gut development and postnatal adaptation

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

Conclusion

The balance between the multiple developing structures and their function probably determines whether a state of health can be achieved at a given gestational age. The diversity of possible influences explains the difficulties in clarifying the etiology of disease states such as necrotizing enterocolitis. Studies of fetal animals but also especially carefully conducted studies in human preterm babies will further advance our understanding of the normal development of small intestinal function and of the influence of external factors such as intercurring clinical problems and therapeutic interventions. It can be expected that using animal models and relatively non-invasive methods in a clinical situation our knowledge regarding the development of gastro-intestinal function will progress and the medical care of perterm infants, especially their nutritional support, will continue to improve.

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

ENS :

enteric nervous system

GIP :

gastric inhibitory polypeptide

VIP :

vasoactive intestinal peptide

MMC :

migrating motor complex

References

  1. Adrian TE (1993) Gastrointestinal hormones. In: Gluckman PD, Heymann MA (eds) Permatal and pediatric pathophysiology: a clinical perspective. Hodder and Stoughton Ltd, Boston, pp 384–390

    Google Scholar 

  2. Aynsley-Green A (1991) Endocrine function of the gut in early life. In: Walker AW (ed) Pediatric gastrointestinal disease, 2 vols. B. C. Decker, Philadelphia, pp 1:236–255

    Google Scholar 

  3. Bernbaum Pereira GR, Watkins JB, Peckham GJ (1983) Nonnutritive sucking during gavage feeding enhances growth and maturation in premature infants. Pediatrics 71:41–45

    PubMed  Google Scholar 

  4. Berseth CL (1989) Gestational evolution of small intestine motility in preterm and term infants. J Pediatr 115:646–651

    PubMed  Google Scholar 

  5. Berseth CL (1990) Neonatal small intestinal motility: motor responses to feeding in term and preterm infants. J. Pediatr 117:777–782

    PubMed  Google Scholar 

  6. Berseth CL (1992) Effect of early feeding on maturation of the preterm infant's small intestine. J Pediatr 120:947–953

    PubMed  Google Scholar 

  7. Berseth CL, McCoy HH (1992) Birth asphyxia alters neonatal intestinal motility in term neonates. Pediatrics 90:669–673

    PubMed  Google Scholar 

  8. Berseth CL, Nordyke C (1993) Enteral nutrients promote postnatal maturation of intestinal motor activity in preterm infants. Am J Physiol 264:G1046-G1051

    PubMed  Google Scholar 

  9. Berseth CL, Nordyke CK (1992) Manometry can predict feeding readiness in preterm infants. Gastroenterology 103:1523–1528

    PubMed  Google Scholar 

  10. Bisser WM (1988) The development of motor control systems in the gastrointestinal tract of the preterm infant. Disorders of gastrointestinal motility in childhood. John Wiley, Chichester, pp 17–27

    Google Scholar 

  11. Bisset WM (1988) Intestinal motor activity in the pretern infant. In: Milla PJ (ed) Disorders of gastrointestinal motility in childhood. John Wiley, Chichester, pp 29–37

    Google Scholar 

  12. Boedeker EC, Latimer JS (1991) Flora of the gut and protective function. In: Walker WA (ed) Pediatric gastrointestinal disease, 2 vols. B.C. Decker, Philadelphia, pp 1:281–299

    Google Scholar 

  13. Brown BH, Barber DC, Seagar AD (1985) Applied potential tomography: possible clinical applications. Clin Phys Physiol Meas 9:499–507

    Google Scholar 

  14. Bryant MG, Buchan AMJ, Gregor M, Ghatei MA, Polak JM, Bloom SR (1982) Development of intestinal regulatory peptides in humans. Gastroenterology 83:47–54

    PubMed  Google Scholar 

  15. Carey MC, Hernell O (1992) Digestion and absorption of fat. Semin Gastrointes Dis 3:189–208

    Google Scholar 

  16. Casaer P, Daniels H, Devlieger H, DeCock P, Eggermont E (1982) Feeding behaviour in preterm neonates. Early Hum Dev 7:331–346

    PubMed  Google Scholar 

  17. Cavell B (1979) Gastric emptying in preterm infants. Acta Paediatr Scand 68:725–730

    PubMed  Google Scholar 

  18. Christensen J (1988) The enteric nervous system. In: Kumar D, Gustavsson S (eds) An illustrated guide to gastrointestinal motility. John Wiley, New York, pp 9–31

    Google Scholar 

  19. De Vries JIP, Visser GHA, Prechtl HFR (1982) The emergence of fetal behaviour. I. Qualitative aspects. Early Hum Dev 7:301–322

    PubMed  Google Scholar 

  20. Dumont RC, Rudolph CD (1994) Development of gastrointestinal motility in the infant and the child. Gastroenterol Clin North Am 23:655–671

    PubMed  Google Scholar 

  21. Eggermont E (1969) The hydrolysis of the naturally occurring alfa-glucosides by the human intestinal mucosa. Eur J Biochem 9:483–487

    PubMed  Google Scholar 

  22. Eggermont E (1991) Problems of transfer of carbohydrates at the level of the intestinal mucosa. In: Schaub J, Van Hoof F, Vis HL (eds) Inborn errors of metabolism. Nestle Nutrition Workshop Series. Raven Press, New York, pp 24:197–205

    Google Scholar 

  23. Epstein ML, Rudolph CD (1993) Embryology and anatomy of the gastrointestinal tract. In: Gluckmann PD, Heymann MA (eds) Perinatal pediatric pathophysiology: a clinical perspective. Hodder and Stoughton, Boston; pp 376–379

    Google Scholar 

  24. Geboes K, Spiessens C, Nijs G, Witte P de (1993) Anthranoids and the mucosal immune system of the colon. Pharmacol 47 [Suppl 1]:49–57

    Google Scholar 

  25. Gershon MD, Wade PR (1994) New developments in the enteric nervous system. Curr Opin Gastroenterol 10:183–192

    Google Scholar 

  26. Goldstein I, Lockwood C, Hobbins JC (1987) Ultrasound assessment of fetal intestinal development in the evaluation of gestational age. Obstet Gynecol 70:682–686

    PubMed  Google Scholar 

  27. Grundy D (1985) Gastrointestinal motility. The integration of physiological mechanisms. MTP Press, Lancaster, pp 145–167

    Google Scholar 

  28. Hillemeicr AC, Lange R, McCallum R, Seashore J, Gryboski J (1981) Delayed gastric emptying in infants with gastroesophageal reflux. J Pediatr 98:190–193

    PubMed  Google Scholar 

  29. Ittmann PI, Amarmath RP, Berseth CL (1992) Maturation of antroduodenal motor activity in preterm and term infants. Dig Dis Sci 37:14–19

    PubMed  Google Scholar 

  30. Kobayashi S, Uchida T (1990) Morphological identification of motilin in the gut. In: Itoh Z (ed) Motilin. Academic Press, San Diego; pp 53–72

    Google Scholar 

  31. Laissue JA, Chappuis BB, Muller C, Reubi JC, Gebbers JO (1993) The intestinal immune system and its relation to disease. Dig Dis 11:298–312

    PubMed  Google Scholar 

  32. Langman J (1976) Fourth to eight week of development. In: Langman I (ed) Introduction to embryology. Bohn, Scheltema and Holkema, Utrecht, pp 70–76 (in Dutch)

    Google Scholar 

  33. Lucas A, Bloom SR, Green AA (1985) Gastrointestinal peptides and the adaptation to extrauterine nutrition. Can J Physiol Pharmacol 63:527–537

    PubMed  Google Scholar 

  34. McClelland GR, Sutton JA (1985) Epigastric impedance: a non-invasive method for the assessment of gastric emptying and motility. Gut 26:607–614

    PubMed  Google Scholar 

  35. McLain C (1963) Amniography studies of the gastrointestinal tract of the human fetus. Am J Obstet Gynecol 86:1079–1087

    PubMed  Google Scholar 

  36. Milla PJ (1986) Intestinal motility and its disorders. Clin Gastroenterol 15: 121–136

    PubMed  Google Scholar 

  37. Milla PJ (1991) Feeding, tasting, and sucking. In: Walker WA (ed) Pediatric gastrointestinal disease. 2 vols. B. C. Decker, Philadelphia, pp 1:217–223

    Google Scholar 

  38. Nour S, Mangnall YF, Dickson JAS, Johnson AG, Pearse RG (1995) Applied potential tomography in the measurement of gastric emptying in infants. J Pediatr Gastroenterol Nutr 20:65–72

    PubMed  Google Scholar 

  39. Phillips SF (1988) Small bowel. In: Kumar D, Gustavsson S (eds) An illustrated Guide to Gastrointestinal Motility. John Wiley, New York, pp 187–206

    Google Scholar 

  40. Pritchard JA (1966) Fetal swallowing and amniotic fluid volume. Obstet Gynecol 28:606–610

    PubMed  Google Scholar 

  41. Samson WK, Lumpkin MD, McCann SM (1982) Motilin stimulates growth hormone release in vitro. Brain Res Bull 8:117–121

    PubMed  Google Scholar 

  42. Schmitz J (1991) Digestive and absorptive function. In: Walker WA (ed) Pediatric gastrointestinal disease, 2 vols. B. C. Decker, Philadelphia, pp 1:266–280

    Google Scholar 

  43. Siegel M, Lebenthal E, Topper WBK, Li PK (1982) Gastric emptying in prematures of isocaloric feedings with different osmolatities. Pediatr Res 16:141–147

    PubMed  Google Scholar 

  44. Siegel M, Lebenthal E, Krantz B (1984) Effect of caloric density on gastric emptying in premature infants. J Pediatr 104:118–122

    PubMed  Google Scholar 

  45. Siegel M, Krantz B, Lebenthal E (1985) Effect of fat and carbohydrate composition on the gastric emptying of isocaloric feedings in premature infants. Gastroenterology 89:785–790

    PubMed  Google Scholar 

  46. Spencer J, Isaacson PG, Walker-Smith JA, MacDonald TT (1989) Heterogeneity in intraepithelial lymphocyte subpopulations in fetal and postnatal human small intestine. J Pediatr Gastroenterol Nutr 9:173–177

    PubMed  Google Scholar 

  47. Szabo SJ, Hillemeier AC, Oh W (1985) Effect of non-nutritive and nutritive suck on gastric emptying in premature infants. J Pediatr Gastroenterol Nutr 4:348–351

    PubMed  Google Scholar 

  48. Tache Y, Wingate D (1991) Brain-gut interactions. CRC Press. Boca Raton, FL

    Google Scholar 

  49. Udall JN, Watson RR (1991) Development of immune function. In: Walker WA (ed) Pediatric gastrointestinal discase. 2 vols. B. C. Decker, Philadelphia pp 1:300–311

    Google Scholar 

  50. Uvnäs-Moberg K (1989) The gastrointestinal tract in growth and reproduction. Scient Am 60–65

  51. Vantrappen G, Janssen J, Ghoos Y (1977) The interdigestive motor complex of normal subjects and patients with bacterial overgrowth of the small intestine. J Clin Invest 59:1158–1166

    PubMed  Google Scholar 

  52. Veereman-Wauters G (1995) Aspects of the development of gastrointestinal function. Catholic University of Leuven.

  53. Veereman-Wauters G, Ghoos Y, Shoor S van der, Maes B, Hebbalkar N, Devlieger H, Eggermont E. The 13C-octanoic acid breath test: a non invasive technique to assess gastric emptying in preterm infants. J Pediatr Gastroenterol Nutr (in press)

  54. Weaver LT (1991) Development of the gastrointestinal tract and accessory organs. Anatomy and embryology. In: Walker WA (ed) Pediatric gastrointestinal disease, 2 vols. B. C. Decker, Philadelphia, pp 1:195–216

    Google Scholar 

  55. Zilianti M, Fernandez S (1983) Correlation of ultrasonic images of fetal intestine with gestational age and fetal maturity. Obstet Gynecol 62:569–573

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Gastro-enterology, University Hospitals Leuven, U. Z. Gasthuisberg, Herestraat, 49, B-3000, Leuven, Belgium

    G. Veereman-Wauters

Authors
  1. G. Veereman-Wauters
    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

Veereman-Wauters, G. Neonatal gut development and postnatal adaptation. Eur J Pediatr 155, 627–632 (1996). https://doi.org/10.1007/BF01957141

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01957141

Key words

Search

Navigation