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Gastrointestinal System and Neonatal Nutrition

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Textbook of Clinical Pediatrics

Introduction

The intestine is one of the most active and complex organ systems in the body. As an example of its complexity, it is notable that the system contains neural tissue equivalent to the entire spinal cord. The intestine is involved in important endocrine and exocrine roles and also serves as the largest and most active immune organ of the body. In addition to the intestine itself, the luminal microbiota and its interactions with the intestinal mucosa and submucosa are becoming increasingly recognized as critical in postnatal development and lifelong health and disease. In addition to these seemingly newfound GI tract functions, its classic role in digestion and absorption of nutrients remains of utmost importance in health and needs to be understood in order to optimize nutrition during these highly critical windows of development.

Dramatic events in gastrointestinal (GI) system development begin in the 3rd week of fetal development. Gastrulation, organ formation, growth,...

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References

  • Adamkin DH (2007) Early aggressive nutrition: parenteral amino acids and minimal enteral nutrition for extremely low birth weight (<1,000 g) infants. Minerva Pediatr 59:369–377

    PubMed  CAS  Google Scholar 

  • Anand RJ, Leaphart CL, Mollen KP, Hackam DJ (2007) The role of the intestinal barrier in the pathogenesis of necrotizing enterocolitis. Shock 27:124–133

    Article  PubMed  CAS  Google Scholar 

  • Andrews WW, Goldenberg RL, Hauth JC (1995) Preterm labor: emerging role of genital tract infections. Infect Agents Dis 4:196–211

    PubMed  CAS  Google Scholar 

  • Beck-Sague CM, Azimi P, Fonseca SN, Baltimore RS, Powell DA, Bland LA, Arduino MJ, McAllister SK, Huberman RS, Sinkowitz RL et al (1994) Bloodstream infections in neonatal intensive care unit patients: results of a multicenter study. Pediatr Infect Dis J 13:1110–1116

    PubMed  CAS  Google Scholar 

  • DiGiulio DB, Romero R, Amogan HP, Kusanovic JP, Bik EM, Gotsch F, Kim CJ, Erez O, Edwin S, Relman DA (2008) Microbial prevalence, diversity and abundance in amniotic fluid during preterm labor: a molecular and culture-based investigation. PLoS ONE 3:e3056

    Article  PubMed  Google Scholar 

  • Gitlin D, Kumate J, Morales C, Noriega L, Arevalo N (1972) The turnover of amniotic fluid protein in the human conceptus. Am J Obstet Gynecol 113:632–645

    PubMed  CAS  Google Scholar 

  • Goldenberg RL, Culhane JF, Iams JD, Romero R (2008) Epidemiology and causes of preterm birth. Lancet 371:75–84

    Article  PubMed  Google Scholar 

  • Goldstein I, Reece EA, Yarkoni S, Wan M, Green JL, Hobbins JC (1987) Growth of the fetal stomach in normal pregnancies. Obstet Gynecol 70:641–644

    PubMed  CAS  Google Scholar 

  • Gotsch F, Romero R, Kusanovic JP, Mazaki-Tovi S, Pineles BL, Erez O, Espinoza J, Hassan SS (2007) The fetal inflammatory response syndrome. Clin Obstet Gynecol 50:652–683

    Article  PubMed  Google Scholar 

  • Grand RJ, Watkins JB, Torti FM (1976) Development of the human gastrointestinal tract: a review. Gastroenterology 70:790–810

    PubMed  CAS  Google Scholar 

  • Guillet R, Stoll BJ, Cotten CM, Gantz M, McDonald S, Poole WK, Phelps DL (2006) Association of H2-blocker therapy and higher incidence of necrotizing enterocolitis in very low birth weight infants. Pediatrics 117:e137–e142

    Article  PubMed  Google Scholar 

  • Han YW, Shen T, Chung P, Buhimschi IA, Buhimschi CS (2009) Uncultivated bacteria as etiologic agents of intra-amniotic inflammation leading to preterm birth. J Clin Microbiol 47:38–47

    Article  PubMed  Google Scholar 

  • Hegardt P, Lindberg T, Borjesson J, Skude G (1984) Amylase in human milk from mothers of preterm and term infants. J Pediatr Gastroenterol Nutr 3:563–566

    Article  PubMed  CAS  Google Scholar 

  • Ismail AS, Hooper LV (2005) Epithelial cells and their neighbors. IV. Bacterial contributions to intestinal epithelial barrier integrity. Am J Physiol Gastrointest Liver Physiol 289:G779–G784

    Article  PubMed  CAS  Google Scholar 

  • Jarvenpaa AL (1983) Feeding the low-birth-weight infant. IV. Fat absorption as a function of diet and duodenal bile acids. Pediatrics 72:684–689

    PubMed  CAS  Google Scholar 

  • Jones JB, Mehta NR, Hamosh M (1982) Alpha-amylase in preterm human milk. J Pediatr Gastroenterol Nutr 1:43–48

    Article  PubMed  CAS  Google Scholar 

  • Klenoff-Brumberg HL, Genen LH 2003 High versus low medium chain triglyceride content of formula for promoting short term growth of preterm infants. Cochrane Database Syst Rev:CD002777

    Google Scholar 

  • Lindberg T, Skude G (1982) Amylase in human milk. Pediatrics 70:235–238

    PubMed  CAS  Google Scholar 

  • Liu Z, Li N, Neu J (2005) Tight junctions, leaky intestines, and pediatric diseases. Acta Paediatr 94:386–393

    Article  PubMed  CAS  Google Scholar 

  • McClean P, Weaver LT (1993) Ontogeny of human pancreatic exocrine function. Arch Dis Child 68:62–65

    Article  PubMed  CAS  Google Scholar 

  • McCracken VJ, Lorenz RG (2001) The gastrointestinal ecosystem: a precarious alliance among epithelium, immunity and microbiota. Cell Microbiol 3:1–11

    Article  PubMed  CAS  Google Scholar 

  • Montgomery R (2008) Gastrointestinal development: morphogenesis and molecular mechanisms. In: Neu J (ed) Neonatology questions and controversies: gastroenterology and nutrition. W.B. Saunders, Philadelphia, pp 3–27

    Chapter  Google Scholar 

  • Moxey PC, Trier JS (1978) Specialized cell types in the human fetal small intestine. Anat Rec 191:269–285

    Article  PubMed  CAS  Google Scholar 

  • Nanthakumar NN, Fusunyan RD, Sanderson I, Walker WA (2000) Inflammation in the developing human intestine: a possible pathophysiologic contribution to necrotizing enterocolitis. Proc Natl Acad Sci USA 97:6043–6048

    Article  PubMed  CAS  Google Scholar 

  • Rojas MA, Efird MM, Lozano JM, Bose CL, Rojas MX, Rondon MA, Ruiz G, Pineros JG, Rojas C, Robayo G, Hoyos A, Gosendi MH, Cruz H, O’Shea M, Leon A (2005) Risk factors for nosocomial infections in selected neonatal intensive care units in Colombia, South America. J Perinatol 25:537–541

    Article  PubMed  Google Scholar 

  • Romero R, Mazor M, Wu YK, Sirtori M, Oyarzun E, Mitchell MD, Hobbins JC (1988) Infection in the pathogenesis of preterm labor. Semin Perinatol 12:262–279

    PubMed  CAS  Google Scholar 

  • Romero R, Gomez R, Ghezzi F, Yoon BH, Mazor M, Edwin SS, Berry SM (1998) A fetal systemic inflammatory response is followed by the spontaneous onset of preterm parturition. Am J Obstet Gynecol 179:186–193

    Article  PubMed  CAS  Google Scholar 

  • Romero R, Espinoza J, Goncalves LF, Kusanovic JP, Friel L, Hassan S (2007) The role of inflammation and infection in preterm birth. Semin Reprod Med 25:21–39

    Article  PubMed  CAS  Google Scholar 

  • Roy CC, Ste-Marie M, Chartrand L, Weber A, Bard H, Doray B (1975) Correction of the malabsorption of the preterm infant with a medium-chain triglyceride formula. J Pediatr 86:446–450

    Article  PubMed  CAS  Google Scholar 

  • Sharma R, Tepas JJ 3rd, Hudak ML, Mollitt DL, Wludyka PS, Teng RJ, Premachandra BR (2007) Neonatal gut barrier and multiple organ failure: role of endotoxin and proinflammatory cytokines in sepsis and necrotizing enterocolitis. J Pediatr Surg 42:454–461

    Article  PubMed  Google Scholar 

  • Sharma R, Young C, Mshvildadze M, Neu J (2009) Intestinal microbiota: does it play a role in diseases of the neonate? Neoreviews 10:e166–e179

    Article  Google Scholar 

  • Shulman RJ, Schanler RJ, Lau C, Heitkemper M, Ou CN, Smith EO (1998) Early feeding, feeding tolerance, and lactase activity in preterm infants. J Pediatr 133:645–649

    Article  PubMed  CAS  Google Scholar 

  • Simmer K, Schulzke SM, Patole S (2008) Longchain polyunsaturated fatty acid supplementation in preterm infants. Cochrane Database Syst Rev:CD000375

    Google Scholar 

  • Weaver LT, Austin S, Cole TJ (1991) Small intestinal length: a factor essential for gut adaptation. Gut 32:1321–1323

    Article  PubMed  CAS  Google Scholar 

  • Young C, Sharma R, Handfield M, Mai V, Neu J (2009) Biomarkers for infants at risk for necrotizing enterocolitis: clues to prevention? Pediatr Res 65:91R–97R

    Article  PubMed  CAS  Google Scholar 

  • Ziegler EE (2007) Protein requirements of very low birth weight infants. J Pediatr Gastroenterol Nutr 45(Suppl 3):S170–S174

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Christopher Young M.D. .

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Young, C., Mshvildadze, M., Neu, J. (2012). Gastrointestinal System and Neonatal Nutrition. In: Elzouki, A.Y., Harfi, H.A., Nazer, H.M., Stapleton, F.B., Oh, W., Whitley, R.J. (eds) Textbook of Clinical Pediatrics. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-02202-9_25

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  • DOI: https://doi.org/10.1007/978-3-642-02202-9_25

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-02201-2

  • Online ISBN: 978-3-642-02202-9

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