Enzyme Boost for Preemies?

Premature infants who receive small amounts of breast milk or formula within days of birth--in addition to intravenous feedings--may get a much needed boost in intestinal development. This may enable the infants to more quickly tolerate regular feedings, a prerequisite for release from the hospital.

Preliminary findings of a study at the Agricultural Research Service, based on the progress of 70 premature infants weighing less than 2.5 pounds at birth, indicate that early feedings stimulate production of lactase.

Lactase is the enzyme that digests the major milk sugar, lactose.

For years, very low birth weight infants have received intravenous (IV) feedings exclusively for the first two weeks. Because these infants didn’t produce the lactase enzyme, doctors thought the undigested sugar from breast milk or formula would increase the risk of necrotizing enterocolitis--a serious complication that destroys the intestinal lining. But this ongoing study strongly suggests that the advantages of early feedings outweigh the disadvantages.

Half the infants were introduced to less than one-quarter cup of breast milk or formula each day beginning only four days after birth. The other half received only IV feedings for two weeks. A test administered three times during their first month showed that the early feeding group had significantly higher lactase activity for the first three weeks.

Scientific contact: Robert Shulman, ARS Children’s Nutrition Research Center, Houston, Texas, phone (713) 798-7145.