Abstract
Extrauterine growth restriction often occurs in premature infants but may be mitigated by optimizing enteral feeding strategies. We show that intermittent bolus feeding does not increase skeletal muscle protein synthesis, myonuclear accretion, or lean growth more than continuous feeding in preterm pigs. This attenuated anabolic response of muscle to intermittent bolus feeding, compared with previous observations in pigs born at term, may contribute to deficits in lean mass that many premature infants exhibit into adulthood.
Highlights
The incidence of preterm birth in the United States is increasing and accounts for $1 in 10 births [1]
We show that intermittent bolus feeding does not increase skeletal muscle protein synthesis, myonuclear accretion, or lean growth more than continuous feeding in preterm pigs
We determined previously that in neonatal pigs born at term, intermittent bolus feeding results in greater lean mass accretion than providing the same nutrient quantities as a continuous feed [19, 20, 22, 23]
Summary
The incidence of preterm birth in the United States is increasing and accounts for $1 in 10 births [1]. Despite advancements in perinatal medicine, premature infants are still at high risk for poor growth outcomes and are frequently discharged weighing less than the 10th percentile for age [2]. Postnatal growth failure is associated with adverse long-term health outcomes including impaired cognitive and neurological development, compromised motor function, less skeletal muscle mass, and increased risk for developing obesity, insulin resistance, and heart disease [3,4,5]. The immature gastrointestinal function of premature infants limits the rapid advancement of enteral feeding and may lead to persistent deficits in energy and protein intake that preclude adequate growth [6,7,8,9]. Strategies to promote lean growth while minimizing fat accretion in premature infants are needed
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