The Risk of Necrotizing Enterocolitis Differs among Preterm Pigs Fed Formulas with Either Lactose or Maltodextrin

Randal K. Buddington, Samantha L. Davis, Randal Buddington

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: When breast milk is unavailable for preterm infants, formulas are needed that won't increase the risk of necrotizing enterocolitis (NEC). Adding novel ingredients to formula to reduce NEC has not been effective clinically. Instead, we tested the prediction that NEC can be reduced by removing the maltodextrin now included in preterm formulas. Methods: The preterm pig model of spontaneous NEC was used to evaluate growth, health, and intestinal responses to 6 to 7 days of feeding formulas that were identical except for the source of carbohydrate; either 100% lactose or maltodextrin; colostrum was used as the control. Results: Formula with maltodextrin resulted in a 50% incidence of NEC with 30% mortality. The lactose formula and colostrum resulted in a 0% incidence of NEC. Growth was highest for pigs fed the formula with lactose, intermediate with maltodextrin, and minimal when bovine colostrum was fed (P < 0.05). Although the small intestine was larger when colostrum was fed (P < 0.05), because rates of glucose uptake were lower (P < 0.05), total small intestine capacities to transport glucose were similar for healthy pigs in all 3 groups. Conclusions: If lactose-based formulas reduce NEC clinically, the transition of preterm infants to enteral feeding can be accelerated, improving growth and development, and shortening reliance on parenteral nutrition. Although colostrum protects against NEC, chronic feeding does not promote body weight gain after preterm birth. The preterm pig can be used for preclinical studies that evaluate the mechanisms by which carbohydrates and other ingredients influence growth, development, health, and risk of NEC.

Original languageEnglish (US)
Pages (from-to)e61-e66
JournalJournal of pediatric gastroenterology and nutrition
Volume66
Issue number3
DOIs
StatePublished - Mar 1 2018

Fingerprint

Necrotizing Enterocolitis
Lactose
Swine
Colostrum
Growth and Development
Premature Infants
Small Intestine
Carbohydrates
maltodextrin
Glucose
Infant Formula
Incidence
Parenteral Nutrition
Premature Birth
Health
Enteral Nutrition
Human Milk
Growth
Weight Gain
Body Weight

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Gastroenterology

Cite this

The Risk of Necrotizing Enterocolitis Differs among Preterm Pigs Fed Formulas with Either Lactose or Maltodextrin. / Buddington, Randal K.; Davis, Samantha L.; Buddington, Randal.

In: Journal of pediatric gastroenterology and nutrition, Vol. 66, No. 3, 01.03.2018, p. e61-e66.

Research output: Contribution to journalArticle

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