SLOW INFUSION FEEDINGS ENHANCE DUODENAL MOTOR-RESPONSES AND GASTRIC-EMPTYING IN PRETERM INFANTS

It is unknown whether it is better to feed preterm infants intragastri cally by bolus or continuous infusion. This study compared the effect of 2 feeding rates on antral and duodenal motor responses and gastric emptying. Continuous per fusion manometry with a low-compliance machin e was performed in 22 infants given feedings at 2 infusion rates. Gast ric emptying was also assessed by using a dye-dilution technique to de termine whether changes in motor response were reflected by changes in function. The number of antral contractions with both feeding rates d ecreased from that seen during fasting. Duodenal motor responses incre ased when infants were fed by slow infusion and decreased when they we re fed by rapid infusion. Infants emptied 12 mL/kg of a 20-mL/kg feedi ng by 20 min after completion of the feeding given by slow infusion co ncomitantly with the increase in duodenal motor activity but only 8 mL /kg by 20 min after completion of the bolus feeding, when duodenal mot or activity decreased (P <0.01). Two hours after completion of the fee ding, volumes remaining in the stomach after slow infusion were one-ni nth those remaining after bolus feeding. When preterm infants are fed by slow infusion over 120 min, their duodenal motor responses are more like those observed in adults and their gastric contents are emptied faster and more completely than when they are fed with a rapid bolus.