GESTATIONAL AND POSTNATAL MATURATION OF DUODENAL MOTOR-RESPONSES TO INTRAGASTRIC FEEDING

Objective: Continuous perfusion manometry was performed in 93 preterm and 14 term infants, none of whom had ever been fed enterally, to dete rmine whether duodenal motor responses to bolus feeding differ in pret erm and term infants. Study design: Motor activity was recorded for 6 hours: 4 hours before and 2 hours after an intragastric feeding compos ed of Similac Special Care Formula, 5 ml/kg, infused for 15 minutes. R esults: Although 12 of 14 term infants had an increase in duodenal mot or activity postprandially, similar to that seen in adults (i.e., a ma ture fed response), only 32 of the 93 preterm infants did (chi square statistic=13.2; p <0.001). In contrast to these infants, 2 term and 77 preterm infants had a decrease in duodenal motor activity (i.e., an i mmature fed response). There was a significant increase in the number of peaks per 30 minutes in the postprandial recordings of infants who demonstrated the ''mature fed response'' and a significant decrease in the number of peaks per 30 minutes in the postprandial recordings of infants who had an ''immature fed response'' (all p <0.05). We then re evaluated motor responses to feeding among 41 of the preterm infants a fter they had received small enteral feedings of 24 ml/kg per day for 7 to 10 days. Although 11 of these infants had exhibited a mature resp onse at the time of their initial study, 25 did at the time of the sec ond study (p <0.03). Conclusion: The duodenal motor response to bolus feeding differs in preterm and term infants; however, with enteral fee ding experience, preterm infants begin to demonstrate more mature duod enal motor responses to feeding.