Absorption of lactose, glucose polymers, or combination in premature infants

Abstract

Study objective: To determine the digestion and absorption of lactose, a combination of lactose and glucose polymers, and glucose polymers alone in infants born at 28 to 42 weeks of gestation. Design: Each infant received the three carbohydrate solutions (85 gm/L concentration) in random order. Setting: Tertiary care urban children's hospital. Interventions: A double-lumen perfusion catheter was placed in the duodenum-jejunum. Absorption was defined as the disappearance of the carbohydrate and all its components (e.g., for lactose: galactose, glucose). Measurements and main results: Absorption of lactose was less than that of the lactose–glucose polymer combination and the glucose polymers alone. There was no relationship between lactose absorption and postnatal age, whereas absorption of the lactose–glucose polymer combination and the glucose polymers alone correlated with age. Lactose absorption was not related to the number of days that the infants received full-strength feedings or the total number of days of feeding before the study, whereas absorption of both the lactose–glucose polymer combination and the glucose polymers alone was related to both. Absorption of the three solutions was not related to gestational age or to the number of days before the initial feeding. Lactose absorption was greater in infants who received formula alone than in infants fed formula together with human milk. Conclusions: Premature infants do not digest and absorb lactose as well as glucose polymers. However, lactose does not impair the absorption of glucose polymers. Lactose assimilation is not affected by maturation, but the type of diet may affect lactose digestion and absorption. In contrast, digestion and absorption of glucose polymers are related to both postnatal age and diet. (J P EDIATR 1995; 127:626-31)