Early feeding, feeding tolerance, and lactase activity in preterm infants☆,☆☆,★,★★
Section snippets
Study Design
Infants in the study were part of a prospective feeding trial.12 They were enrolled within 96 hours of birth, stratified by gestational age (26 to 27 vs 28 to 30 weeks) and by diet (mothers’ own milk vs preterm formula), and assigned randomly among 4 treatment combinations in a balanced 2-way design where the 2 factors were the time of initiation of feeding (early, 4 days of age vs standard, 15 days of age) and the method of tube feeding (continuous infusion vs bolus). The 4 treatment
Results
Although the data at 28 days (Table I) taken in isolation suggest a difference between the early continuous and the early bolus groups, it should be borne in mind that the actual analysis took into account the repeated measures nature of the study (ie, the change over time; see Data Analyses).
Age (d) Group Early continuous Early bolus Standard continuous Standard bolus 10 2.8 ± 3.5* 3.4 ± 3.8 1.4 ± 1.1 1.3 ± 0.8 28 8.0 ± 5.4 12.1 ± 7.7 6.5 ± 4.3 7.3 ±
Discussion
Early enteral feeding had a marked effect on the development of lactase activity. Lactase activity rose at a faster rate in the early group than in the standard group. At 10 days of age lactase activity was >100% greater than that measured in the standard group and at 28 days of age was still 60% greater. These results cannot be explained by differences in clinical characteristics of the infants or the infants’ nutritional history, because these were comparable between groups. Our data also
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Cited by (0)
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From USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Department of Pathology, Baylor College of Medicine; Texas Children’s Hospital, Houston, Texas, and Department of Biobehavioral Nursing, University of Washington, Seattle, Washington.
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Supported by the National Institute of Child Health and Human Development, grant No. RO-1-HD-28140, the American Gastroenterological Association, Smith-Kline Beecham Clinical Research Award, the General Clinical Research Center MO1 RR-00188, and the USDA/ARS under Cooperative Agreement No. 58-6250-1-003. This work is a publication of the USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas. The contents of this publication do not necessarily reflect the views or policies of the USDA, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government.
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Reprint requests: Robert J Shulman, MD, 1100 Bates St, Houston, TX 77030.
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