FEEDING INTOLERANCE IN PREMATURE INFANTS

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. ABSTRACT HYPOTHESIS We hypothesize that in preterm infants 25 to 32 weeks gestational age the following tests: Measurement of: a. Gastric emptying measured using the 13C-octanoic acid breath test; b. Gastrointestinal mucosal integrity determined withthe sucrose/lactulose/mannitol/sucralose urinary excretion (permeability) test (PT); c. Lactase activity measured using the lactase activity test (part of the PT); and d. Fecal excretion (concentrations) of calprotectin and alpha-1-antitrypsin. 1. Can detect the presence of feeding intolerance (defined by increased gastric residuals, abnormal clinical abdominal examination, presence of green gastric residuals) before it becomes clinically apparent; and 2. Can be used to predict the time required to reach full enteral feedings. II. SPECIFIC AIMS The long-term goals of our research program are to reduce the adverse consequences of preterm birth related to underdevelopment of the gastrointestinal (GI) tract. Complications related to GI immaturity are responsible for increasing illness severity (including causing death) and ultimately prolonging hospitalization. We seek to derease the emotional and economic burden related to feeding problems (intolerance) that result from underdevelopment of the GI tract. The objectives of the current proposal are to: 1. Develop markers of feeding intolerance; and 2. Test their sensitivity, specificity, positive and negative predictive value in the early identification of feeding intolerance.