Dietary carbohydrate assimilation in the premature infant: Evidence for a nutritionally significant bacterial ecosystem in the colon

C. L. Kien, E. A. Liechty, D. Z. Myerberg, M. D. Mullet

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39 Scopus citations


Carbohydrate energy absorption and breath hydrogen concentration were measured in 12 premature infants 28-32 wk gestational age and 2-4 wk postnatal age. Each of two groups of six infants were randomly assigned to receive one of two formulas that differed only in carbohydrate source: 100% lactose (LAC) or 50% lactose: 50% glucose polymer (LAC + GP). In 11 infants the peak breath hydrogen concentrations suggested extensive colonic fermentation (range 44-239 ppm/5% CO2 or 44-239 μL/L per 50 mL/L CO2). An approximate 100% increase in lactose intake in the LAC group was associated with a similar increase in breath hydrogen concentration at 30, 60, and 120 min. None of the infants exhibited diarrhea or vomiting or developed delayed gastric emptying. Carbohydrate energy absorption (χ̄ ± SD) was, respectively, 86 ± 5% and 91 ± 3% in the LAC and the LAC+ GP groups (p > 0.05). Thus, colonic bacterial fermentation may be critical to energy balance and to the prevention of osmotic diarrhea in premature infants fed lactose.

Original languageEnglish (US)
Pages (from-to)456-460
Number of pages5
JournalAmerican Journal of Clinical Nutrition
Issue number3
StatePublished - Jan 1 1987


ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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