Abstract
we have shown that the first feed of breast milk in term infants causes increases in the levels of blood glucose, plasma insulin, growth hormone. gastrin and enteroglucagon.1 We now report the effects of the first feed in two groups of pre-term infants at 28-33 weeks (Group I, n:8, given an intragastric bolus of 2.5 m1/Kg breast milk; Group II, n:5, given a continuous gastric infusion of 2.5 m1/Kg/hour) in order to compare the results with those from term infants. Basal concentrations of blood glucose, lactate and pyruvate were similar in term and pre-term infants, but blood ketones were significantly lower in pre-term infants (0.09 ± 0.03 mmo1/1 vs 0.25 ± 0.04 mmo1/1, p<0.01). No change in blood glucose followed the feed in either pre-term group in contrast to the increase seen in term infants (mean Δ glucose 0.84 mmo1/1). Basal concentrations of plasma insulin and enteroglucagon were similar in term and pre-term infants but the post-prandial increases in both hormones in term infants were not seen in the groups of pre-term infants. Mean basal growth hormone level was higher in pre-term infants (27.7 ± 5.7 μg/1 vs 17.7 ± 3.2 μg/1 p<0.05) but the post-prandial increase in term infants did not occur in pre-term infants. The metabolic and endocrine changes seen in term infants after the first feed do not occur in pre-term infants with standard methods of feeding.
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Lucas, A., Bloom, S. & Aynsley-Green, A. Metabolic and endocrine events at the time of the first feed of human milk in preterm and term infants. Pediatr Res 13, 80 (1979). https://doi.org/10.1203/00006450-197901000-00064
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DOI: https://doi.org/10.1203/00006450-197901000-00064