Abstract
Small intestinal motor activity is characterised by a cyclical pattern of activity which is disrupted following food and is replaced by a continuous fed pattern. In the preterm infant, however, both patterns are poorly developed.
Using constantly perfused multilumen jejunal catheters we have studied the effect of enteral feeding on small intestinal motor activity in 10 preterm infants studied on 23 occasions between 28 and 44 weeks gestation. When given a bolus feed appropriate to the infants age, the fasting pattern was not disrupted or replaced by a fed pattern in the very preterm infant (28-30 weeks) but disruption and the appearance of the fed pattern increased with increasing gestational age (r=0.6, p=0.005), increasing fasting motor maturation (r=0.6, p=0.005), reduced feed frequency (r=0.66, p=0.001) increasing feed volume (r=0.8, p<0.0001) and particularly with increased time fed enterally (r=0.87, p<0.0001).
These data suggest that although gestational age and fasting motor maturation are important, the major determinants in the development of mature postprandial activity in the preterm infant is the exposure of the intestine to enteral nutrition and the introduction of bolus feeds.
The adoption of these feeding practices should facilitate intestinal motor development and enteral feeding tolerance.
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Bisset, W., Watt, J., Rivers, R. et al. 27. THE MOTOR RESPONSE OF THE SMALL INTESTINE TO MILK FEEDS IN PRETERM INFANTS. Pediatr Res 22, 100 (1987). https://doi.org/10.1203/00006450-198707000-00048
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DOI: https://doi.org/10.1203/00006450-198707000-00048