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Query: UMLS:C0728731 (prematurity)
 7,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fats provide 40-50% of the total calories in human milk or infant formula. The milk secreted by mothers of preterm infants differs in fat composition from that of mothers of full-term infants in having higher levels of medium chain fatty acids (C12, C14) throughout the first 3 months of lactation, and higher levels of long chain polyenoic fatty acids during the first 3 months of lactation. These differences in composition benefit the preterm infant by providing higher levels of rapidly absorbed medium chain fatty acids and long chain polyenoic fatty acids needed for brain development. Fat digestion: The low levels of pancreatic lipase and bile salts in the preterm infant are compensated for by lipolysis in the stomach by lingual and gastric lipase and by the intestinal hydrolysis of fat through the action of human milk bile salt-stimulated lipase. Fat digestion is efficient in the preterm infant who absorbs about 80-90% of ingested fat. Lipid clearing from the circulation depends upon the activity of the enzymes lipoprotein lipase, hepatic lipase, and lecithin-cholesterol acyltransferase. The activity of these enzymes is lower or equal to that of term infants, depending upon the degree of prematurity and the nutritional regimen, especially in parenterally fed infants.
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PMID:Lipid metabolism in premature infants. 332 34

The effect of diet, human milk or formula, on gastric function (lipase and pepsin activity, pH, and volume) and intragastric digestion of fat was assessed in 28 appropriate for gestational age preterm infants (gestational age, 28.9 +/- 1.4, 29.1 +/- 0.9, 29.5 +/- 0.6 wk; birth weight, 1.00 +/- 0.14 to 1.18 +/- 0.07 kg). The infants were fed either human milk (n = 11), SMA Super Preemie formula (n = 9), or Similac, Special Care formula (n = 8). Fasting and postprandial activity of digestive enzymes, pH, and gastric volume (measured before or during 50 min after gavage feeding) did not differ as a function of diet among the three groups of infants. Gastric lipase output, 23.1 +/- 5.1, 28.3 +/- 6.6, and 22.5 +/- 6.4 (U/kg of body weight) in human milk-, SMA SP-, or Similac SC-fed infants was comparable to the gastric lipase output of healthy adults fed a high fat diet (22.6 +/- 3.0). Pepsin output was, however, significantly lower (597 +/- 77, 743 +/- 97, and 639 +/- 142 U/kg of body weight) in human milk-, SMA SP-, and Similac SC-fed infants) than in healthy adults (3352 +/- 753 U/kg). The hydrolysis of dietary fat was 1.7-2.5-fold higher (p < 0.01) in human milk-fed infants than in infants fed either formula. We conclude that differences in type of feeding, i.e. different fatty acid profiles (long chain or medium chain triglycerides), different emulsions (natural or artificial), and different fat particle sizes do not affect the level of activity of gastric enzymes. However, the triglyceride within milk fat globules appears to be more accessible to gastric lipase than that within formula fat particles. We suggest that the contribution of gastric lipase to overall fat digestion might be greater in the newborn (a period of pancreatic insufficiency) than in the adult.
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PMID:Effect of human milk or formula on gastric function and fat digestion in the premature infant. 886 80