PC78 DOES PASTEURIZATION OF HUMAN MILK INFLUENCE GASTROINTESTINAL TRANSIT TIME IN PRETERM INFANTS <32 WEEKS OF GESTATION?

Abstract

Introduction: Very low birth weight infants often have reduced gastrointestinal motility which may result in delayed enteral feeding. In preterm infants feeding human milk of cytomegalovirus (CMV)-IgG-seropositive mothers may cause symptomatic CMV infection. Pasteurization of human milk prevents postnatal CMV infection but denaturates proteins including growth factors that are not resistant to heat. To our knowledge no data exist on the influence of pasteurization of human milk on the gastrointestinal transit time in preterm infants. Objective: To compare gastrointestinal transit time after feeding untreated versus pasteurized human milk in preterm infants <32 weeks of gestation. Methods: Infants of CMV-IgG-seronegative mothers received untreated (group A) and of CMV-IgG-seropositive mothers pasteurized milk (group B) of their own mother. At the age of 3 and 7 days and at 150 ml/kg&d of enteral feeding infants received 25 mg carmine red with their meal. Time interval to the first red stool was documented. Weight gain and caloric intake were recorded. Results: There were no differences between the two groups with respect to birth weight, gestational age, APGAR score and complications. Median transit time on day 3 was 15 h (range 8–47) in group A (n=7) and 18 h (range 9–78) in group B (n=15) (n.s.). On day 7 median transit time was 14 h (8–40) and 12 h (9–32) in group A (n=21) and B (n=21) respectively (n.s.). The volumes of enteral feeding on day 3 and 7 were not significantly different between the two groups (median 133 versus 106 ml/kg&d, range 76–174 and 72–169 ml/kg&d in A and B respectively). At the time of complete enteral intake (150ml/kg&d) median transit time was 14 h (8–26) in group A (n=15) and 12 h (5–44) in group B (n=15) (n.s.). In addition, age at caloric intake of 80 and 100 kcal/kg&d and weight gain (110% and 120% of birth weight) were not significantly different between the two groups. Conclusion: Pasteurization of human milk does not seem to have a negative influence on gastrointestinal transit time, enteral feeding and weight gain in preterm infants <32 weeks of gestation.