# CARBOHYDRATE ENERGY ABSORPTION IN PREMATURE INFANTS

> **NIH NIH R01** · CHILDREN'S HOSPITAL (COLUMBUS) · 1994 · $271,455

## Abstract

Fetal intestinal lactase activity is extremely low prior to 32 - 34 wk
gestation but appears to rise rapidly thereafter.  Breath H2
concentration and the rate of whole body acetate production are high in
preterm infants 32-36 wk post-conceptional age suggesting that lactose
is largely fermented in the colon, but studies of growth and lactose
tolerance imply that lactose hydrolysis is more efficient in post-natal
life than predicted from these indirect indices of fermentation activity.
During the last year of the present grant, a dual stable tracer technique
was used to estimate a coefficient of in vivo lactose digestion
(hydrolysis) in preterm infants 33-34 wk post-conceptional age.  Based
on the initial values (range:  0.8 - 1.2), it is hypothesized that
lactose digestion is efficient (> 0.8) in preterm infants > 32 wk post-
conceptional age (Aim 3).  The Principal Hypotheses of this proposal
address lactose digestion in preterm infants less than  32 wk post-
conceptional age:  (1) The coefficient of hydrolysis of lactose is < 0.80
and is dependent on the lactose intake.  (2) At the lactose intakes
normally ingested by such infants, the rate of entry into the circulation
of lactose-derived glucose is insufficient to suppress (via insulin
secretion) hepatic glucose output.  To address these hypotheses, four
Primary Specific Aims (Experiments) are proposed:  (1) To define the
reliability of the dual stable tracer technique for estimating lactose
digestion in 5 preterm infants less than  32 wk post-conceptional age.
(2) In 10 preterm infants less than  32 wk post-conceptional age:  to
define a point estimate for lactose digestion; to assess the effect of
doubling the lactose intake on lactose digestion; to estimate the
contribution of lactose-derived glucose and galactose to the systemic
rate of appearance of glucose; and, using the above data, to assess
hepatic glucose output.  (3) By studying 5 additional infants, to
complete the definition of a point estimate of lactose digestion in
preterm infants > 32 wk post-conceptional age.  (4) To define a point
estimate of lactose digestion in 5 preterm infants less than 32 wk post-
conceptional age fed human milk.  The Secondary Aim is to determine the
relationship of the lactose digestibility coefficient to the rate of
breath H2 excretion (measured using a newly developed flow-through
system).  This study may be important to understanding the metabolism of
lactose in preterm infants and should have relevance to the further
development of feeding strategies which minimize formula intolerance and
the risk of necrotizing enterocolitis especially in premature infants
born prior to 30 wk gestational age.

## Key facts

- **NIH application ID:** 2197868
- **Project number:** 5R01HD019773-10
- **Recipient organization:** CHILDREN'S HOSPITAL (COLUMBUS)
- **Principal Investigator:** Craig Lawrence Kien
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1994
- **Award amount:** $271,455
- **Award type:** 5
- **Project period:** 1988-02-01 → 1995-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/2197868

## Citation

> US National Institutes of Health, RePORTER application 2197868, CARBOHYDRATE ENERGY ABSORPTION IN PREMATURE INFANTS (5R01HD019773-10). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/2197868. Licensed CC0.

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