Abstract
Low duodenal bile acid concentrations is the main factor responsible for the fat malabsorption of the newborn and the absorption of MCT is largely independent of micellar solubilisation. One week after birth, 2 isocaloric formulas, of identical protein (casein hydrolysate) and carbohydrate (dextrose) content, differing by the type of fat (MCT vs Long Chain Triglycerides-LCT-) were fed to 25 preterm babies weighing 1300 to 1800 g. During an initial 15 day period, each baby received either MCT or LCT, the alternate formula being given for the second feeding period of identical duration. On MCT, there was a drop in stool fat (7.5→1.1g/72hr) and bile acids 21.9→8.0mg/Kg/72hr as well as a significant increase (P<.001) in fat absorption (83.4%→97.1%) and weight gain (7.5→11.5/Kg/ 24hr/100cal). Because these changes could have been secondary to a significant degree of metabolic acidosis occurring in most of the first 16 babies while on LCT, the chloride content of the formula (33mEq/L) was adjusted to that of the MCT (21mEq/L) before studying the 9 other premies. The beneficial effects of MCT were confirmed and in addition, 3 day balance studies showed an increased (P<.001) nitrogen retention (67.3%→82.1%). MCT would appear to have a place in the dietary management of preterm babies.
Supported by the Mead Johnson Co. of Canada Ltd.
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Roy, C., Ste-Marie, M., Weber, A. et al. CORRECTION OF THE “PHYSIOLOGIC” MALABSORPTION OF THE PREMATURE BY A MEDIUM CHAIN TRIGLYCERIDE(MCT) FORMULA. Pediatr Res 8, 385 (1974). https://doi.org/10.1203/00006450-197404000-00271
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DOI: https://doi.org/10.1203/00006450-197404000-00271