THE ROLE OF FATS IN THE NUTRITION OF CHIL DREN SUFFERING FROM DIARRHEA

Fetal development of the gastrointestinal tract in human beings takes place at an early period of gestation. The pancreas, although mopholog ically developed as early as in the 16th week, does not secrete its ex ocrine enzymes, with the exception of amylase, until the 24th week. Am ylase is not secreted in sufficient activity until the child is six mo nths old. Trypsinogen is activated to form trypsin by the enterokinase which matures in the 24th week, with the result that, by contrast wit h Lipase and colipase, the proteases are not available until week 26. The small intestine begins its morphological and functional maturity a fter the 10th week of gestation. Simultaneously with the development o f fossulae and villi, in weeks 11-12, the enzyme activities of the bru sh border membrane, saccharase-isomaltase, maltase-glycoamylase, and l actase, take place for the first time. At tis time, likewise, the pept idases and the lysosomal enzymes of the mucosa can be measured. With t he exception of lactase, all intestinal enzymes are sufficiently activ e by week 25. Lactase does not rise to full activity until weeks 32-34 . As far as the digestion of carbohydrates is concerned, this means th at premature infants under 1500 g possess adequate preconditions from the point of view of the gastrointestinal tract. The carbohydrates lac tose, saccharose, maltose, and supplemented oligosaccharides, are brok en down by the lactase, saccharase-isomaltase, and by the maltase-gluc oamylase. During the period between weeks 26 and 32, a premature infan t is well prepared for extrauterine feeding by way of the performance of its gastrointestinal tract. Tn the postpartal period, supplementary carbohydrates, including starch, can be satisfactorily hydrolysed and absorbed by the infant's gastrointestinal tract.