Objective: We studied the influence of early minimal enteral nutrition with breast milk (BM) or formula (FF) from day 1 on splanchnic protein turnover as indicator of gut maturation. Subjects: 21 VLBW infants (birthweight (BW) 875-1635 gr.) were randomized to receive total parenteral nutrition (PN) only (n=8), BM 1 ml.kg-1.h-1 (n=6) or FF 1 ml.kg-1.h-1 (n=7) in connection to PN.Methodology: Gut maturation was studied on day 7 by double stable isotope tracers. 1-13C leucine was given as a primed constant infusion intragastric (ig) and 5,5,5-D3 leucine intravenously (iv). Turnover (Q)(μmol.kg-1.h-1) was calculated from theα-keto-isocaproic acid (α-KICA) enrichment in plasma. Qig is the flux calculated from the ig tracer, Q iv from the iv tracer. Splanchnic uptake(SU) of leucine was calculated by the following formula: SU=100*(Qig-Qiv)/Qig. Data is presented as mean±SD.

Results: See table. Conclusions:1) Protein turnover calculated from the iv tracer (Qiv) showed a significant increase from day 1 to day 7 (t-test, P<0.001). 2) Protein turnover calculated from the ig tracer (Qig) showed higher standard deviation than Qiv (t-test, p=0.01) reflecting higher interindividual variability. 3) No significant changes from day 1 to day 7 were observed in splanchnic uptake (t-test, p>0.05) in any of the groups. 4) With this methodology and this amount of enteral feeding we were not able to show a significant effect of enteral nutrition on gut maturation (Anova, p>0.05).

Table 1 No caption available.
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