Skip to main content Accessibility help
×
×
Home

The effect of enteral supplementation of a prebiotic mixture of non-human milk galacto-, fructo- and acidic oligosaccharides on intestinal permeability in preterm infants

  • Elisabeth A. M. Westerbeek (a1), Anemone van den Berg (a2), Harrie N. Lafeber (a1), Willem P. F. Fetter (a1) and Ruurd M. van Elburg (a1)...

Abstract

Preterm infants have an impaired gut barrier function. We aimed to determine the effects of enteral supplementation of a prebiotic mixture consisting of neutral oligosaccharides (short-chain galacto-oligosaccharides (SCGOS)/long-chain fructo-oligosaccharides (LCFOS)) and acidic oligosaccharides (AOS) on intestinal permeability of preterm infants as measured by the sugar absorption test in the first week of life. Furthermore, we determined host- and treatment-related factors associated with intestinal permeability. In a randomised controlled trial, preterm infants with a gestational age < 32 weeks and/or birth weight (BW) < 1500 g received enteral supplementation of SCGOS/LCFOS/AOS or placebo (maltodextrin) between days 3 and 30 of life. Intestinal permeability, reflected by the urinary lactulose/mannitol (L/M) ratio after oral ingestion of lactulose and mannitol, was assessed at three time points: before the start of the study (t = 0), at day 4 (t = 1) and at day 7 (t = 2) of life. Data were analysed by generalised estimating equations. In total, 113 infants were included. Baseline patient and nutritional characteristics were not different between the SCGOS/LCFOS/AOS (n 55) and the placebo groups (n 58). SCGOS/LCFOS/AOS had no effect on the L/M ratio between t = 0 and t = 2. In both the groups, the L/M ratio decreased from t = 0 to t = 2 (P < 0·001). Low BW increased the L/M ratio (P = 0·002). Exclusive breast milk feeding and mixed breast milk/formula feeding during the first week of life decreased the L/M ratio (P < 0·001 and P < 0·05, respectively). In conclusion, enteral supplementation of a prebiotic mixture does not enhance the postnatal decrease in intestinal permeability in preterm infants in the first week of life.

Copyright

Corresponding author

*Corresponding author: Dr R. M. van Elburg, fax +31 20 444 3045, email rm.vanelburg@vumc.nl

References

Hide All
1van den Berg, A, Fetter, WP, Westerbeek, EA, et al. (2006) The effect of glutamine-enriched enteral nutrition on intestinal permeability in very-low-birth-weight infants: a randomized controlled trial. JPEN J Parenter Enteral Nutr 30, 408414.
2van Elburg, RM, Fetter, WP, Bunkers, CM, et al. (2003) Intestinal permeability in relation to birth weight and gestational and postnatal age. Arch Dis Child Fetal Neonatal Ed 88, F52F55.
3Dai, D & Walker, WA (1999) Protective nutrients and bacterial colonization in the immature human gut. Adv Pediatr 46, 353382.
4Van Camp, JM, Tomaselli, V & Coran, AG (1994) Bacterial translocation in the neonate. Curr Opin Pediatr 6, 327333.
5Duffy, LC (2000) Interactions mediating bacterial translocation in the immature intestine. J Nutr 130, 432S436S.
6Shulman, RJ, Schanler, RJ, Lau, C, et al. (1998) Early feeding, antenatal glucocorticoids, and human milk decrease intestinal permeability in preterm infants. Pediatr Res 44, 519523.
7Taylor, SN, Basile, LA, Ebeling, M, et al. (2009) Intestinal permeability in preterm infants by feeding type: mother's milk versus formula. Breastfeed Med 4, 1115.
8Guarner, F & Malagelada, JR (2003) Gut flora in health and disease. Lancet 361, 512519.
9Guarner, F (2007) Studies with inulin-type fructans on intestinal infections, permeability, and inflammation. J Nutr 137, 2568S2571S.
10Boehm, G & Moro, G (2008) Structural and functional aspects of prebiotics used in infant nutrition. J Nutr 138, 1818S1828S.
11Burger-van Paassen, N, Vincent, A, Puiman, PJ, et al. (2009) The regulation of intestinal mucin MUC2 expression by short-chain fatty acids: implications for epithelial protection. Biochem J 420, 211219.
12Kleessen, B, Hartmann, L & Blaut, M (2003) Fructans in the diet cause alterations of intestinal mucosal architecture, released mucins and mucosa-associated bifidobacteria in gnotobiotic rats. Br J Nutr 89, 597606.
13Kleessen, B & Blaut, M (2005) Modulation of gut mucosal biofilms. Br J Nutr 93, Suppl. 1, S35S40.
14Westerbeek, EA, van den Berg, JP, Lafeber, HN, et al. (2009) Neutral and acidic oligosaccharides in preterm infants: a randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 23, 23.
15Olguin, F, Araya, M, Hirsch, S, et al. (2005) Prebiotic ingestion does not improve gastrointestinal barrier function in burn patients. Burns 31, 482488.
16Spindler-Vesel, A, Bengmark, S, Vovk, I, et al. (2007) Synbiotics, prebiotics, glutamine, or peptide in early enteral nutrition: a randomized study in trauma patients. JPEN J Parenter Enteral Nutr 31, 119126.
17Catassi, C, Bonucci, A, Coppa, GV, et al. (1995) Intestinal permeability changes during the first month: effect of natural versus artificial feeding. J Pediatr Gastroenterol Nutr 21, 383386.
18Colomé, G, Sierra, C, Blasco, J, et al. (2007) Intestinal permeability in different feedings in infancy. Acta Paediatr 96, 6972.
19Stratiki, Z, Costalos, C, Sevastiadou, S, et al. (2007) The effect of a bifidobacter supplemented bovine milk on intestinal permeability of preterm infants. Early Hum Dev 83, 575579.
20van Elburg, RM, van den Berg, A, Bunkers, CM, et al. (2004) Minimal enteral feeding, fetal blood flow pulsatility, and postnatal intestinal permeability in preterm infants with intrauterine growth retardation. Arch Dis Child Fetal Neonatal Ed 89, F293F296.
21van den Berg, A, van Elburg, RM, Westerbeek, EA, et al. (2005) Glutamine-enriched enteral nutrition in very-low-birth-weight infants and effects on feeding tolerance and infectious morbidity: a randomized controlled trial. Am J Clin Nutr 81, 13971404.
22Westerbeek, EA, van Elburg, RM, van den Berg, A, et al. (2008) Design of a randomised controlled trial on immune effects of acidic and neutral oligosaccharides in the nutrition of preterm infants: carrot study. BMC Pediatr 8, 46.
23van der Zwet, WC, Kaiser, AM, van Elburg, RM, et al. (2005) Nosocomial infections in a Dutch neonatal intensive care unit: surveillance study with definitions for infection specifically adapted for neonates. J Hosp Infect 61, 300311.
24Twisk, JW, Smidt, N & de Vente, W (2005) Applied analysis of recurrent events: a practical overview. J Epidemiol Community Health 59, 706710.
25Bell, MJ, Ternberg, JL, Feigin, RD, et al. (1978) Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg 187, 17.
26Westerbeek, EA, van den Berg, A, Lafeber, HN, et al. (2006) The intestinal bacterial colonisation in preterm infants: a review of the literature. Clin Nutr 25, 361368.
27van den Berg, A, van Elburg, RM, Westerbeek, EA, et al. (2007) The effect of glutamine-enriched enteral nutrition on intestinal microflora in very low birth weight infants: a randomized controlled trial. Clin Nutr 26, 430439.
28Manzanares, W & Hardy, G (2008) The role of prebiotics and synbiotics in critically ill patients. Curr Opin Clin Nutr Metab Care 11, 782789.
29Weaver, LT, Laker, MF, Nelson, R, et al. (1987) Milk feeding and changes in intestinal permeability and morphology in the newborn. J Pediatr Gastroenterol Nutr 6, 351358.
30Forchielli, ML & Walker, WA (2005) The role of gut-associated lymphoid tissues and mucosal defence. Br J Nutr 93, Suppl. 1, S41S48.
31Forchielli, ML & Walker, WA (2005) The effect of protective nutrients on mucosal defense in the immature intestine. Acta Paediatr Suppl 94, 7483.
32Petrosyan, M, Guner, YS, Williams, M, et al. (2009) Current concepts regarding the pathogenesis of necrotizing enterocolitis. Pediatr Surg Int 25, 309318.
33Zani, A, Ghionzoli, M, Lauriti, G, et al. (2009) Does intestinal permeability lead to organ failure in experimental necrotizing enterocolitis? Pediatr Surg Int 26, 8589.
34Sherman, PM, Cabana, M, Gibson, GR, et al. (2009) Potential roles and clinical utility of prebiotics in newborns, infants, and children: proceedings from a global prebiotic summit meeting, New York City, June 27–28, 2008. J Pediatr 155, S61S70.
35Srinivasjois, R, Rao, S & Patole, S (2009) Prebiotic supplementation of formula in preterm neonates: a systematic review and meta-analysis of randomised controlled trials. Clin Nutr 28, 237242.
36Barrat, E, Michel, C, Poupeau, G, et al. (2008) Supplementation with galactooligosaccharides and inulin increases bacterial translocation in artificially reared newborn rats. Pediatr Res 64, 3439.
37Urao, M, Teitelbaum, DH, Drongowski, RA, et al. (1996) The association of gut-associated lymphoid tissue and bacterial translocation in the newborn rabbit. J Pediatr Surg 31, 14821487.
38Gebbers, JO & Laissue, JA (2004) Bacterial translocation in the normal human appendix parallels the development of the local immune system. Ann N Y Acad Sci 1029, 337343.
39Usher, R & McLean, F (1969) Intrauterine growth of live-born Caucasian infants at sea level: standards obtained from measurements in 7 dimensions of infants born between 25 and 44 weeks of gestation. J Pediatr 74, 901910.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed