Development of Digestive and Absorptive Function in the Human Fetus

Shmerling, D. H.

doi:10.1159/000175689

Cited by 11 publications

(6 citation statements)

References 16 publications

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“…It is reported that bile is secreted from 12 weeks of gestation in the fetus. 15,16 Concentrations of bilirubin and bile acid in the amniotic fluid were reported to be high in cases of intestinal obstruction distal to Vater ampulla. [17][18][19] These findings suggest that UCU is closely related to in utero regurgitation of bile.…”

Section: Discussionmentioning

confidence: 99%

Sudden Fetal Death Associated with Both Duodenal Atresia and Umbilical Cord Ulcer: A Case Report and Review

Anami¹,

Morokuma²,

Tsukimori³

et al. 2006

Amer J Perinatol

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We encountered one case of duodenal atresia complicated by massive intrauterine hemorrhage due to the perforation of an umbilical cord ulceration (UCU). UCU is an extremely rare complication in the perinatal period. Although the prenatal diagnosis of upper intestinal atresia has been established, little is known about the association between UCU and upper intestinal atresia. In this article, we report our case, review past articles, and discuss the underlying pathophysiological mechanisms of the cause of an UCU. Given the characteristic sites of upper intestinal atresia, we speculate that regurgitation of gastric or intestinal juice into the amniotic fluid could be responsible for the development of UCU. We also believe that close observation is required for patients who have upper intestinal atresia.

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Section: Discussionmentioning

confidence: 99%

Sudden Fetal Death Associated with Both Duodenal Atresia and Umbilical Cord Ulcer: A Case Report and Review

Anami¹,

Morokuma²,

Tsukimori³

et al. 2006

Amer J Perinatol

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“…Similar in vitro studies lead to the prediction that the human fetus is able to absorb glucose and digest all three disaccharides (18). I n vitro studies, however, cannot predict whether the human fetus will also develop an increase in IH+I and lactate with carbohydrate feeding.…”

Section: Speculationmentioning

confidence: 97%

“…still lack sucrase and only have very low levels of maltase (21). It is in contrast to the situation in the human fetal intestine where high levels of sucrase and maltase are present by the third trimester (18). Because the pH optimum for maltase is close to 6 (12).…”

Section: Pooled Datamentioning

confidence: 99%

Digestion and Absorption of Carbohydrates by the Fetal Lamb In Utero

Char

Rudolph

1979

Pediatr Res

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SummaryIntestinal digestive function was studied in 12 chronically catheterized third trimester fetal lambs by instilling glucose, fructose, lactose, maltose, and sucrose into their duodenums. Glucose was absorbed rapidly with the peak circulating glucose concentration reached within 1 hr. Fructose was absorbed well, but in contrast to glucose, blood fructose concentration did not peak; it continued to climb for 4 hr. Intraduodenal lactose administration resulted in a rapid rise in blood glucose with the maximum value reached in 1 hr. After receiving either glucose or lactose fetuses older than 130 days showed a faster rise in blood glucose, a greater total increase in glucose and a more rapid return to control levels than the younger fetuses. No change in blood glucose occurred with either maltose or sucrose administration. An increase in lactate concentration and a rise in fetal [H+I were noted after glucose and lactose administration, the only studies in which an increase in blood glucose concentration occurred. SpeculationThe demonstration that the fetal lamb in vivo is able to digest and absorb glucose, fructose, and lactose, but not maltose or sucrose, provides functional validation of prior in vitro studies. Similar in vitro studies lead to the prediction that the human fetus is able to absorb glucose and digest all three disaccharides (18). I n vitro studies, however, cannot predict whether the human fetus will also develop an increase in IH+I and lactate with carbohydrate feeding.Fetal swallowing of amniotic fluid occurs in utero (13). It may, therefore, be possible to inject nutrients into amniotic fluid and have the fetus absorb them through its digestive tract. Fetal carbohydrate absorption has been studied in the past using in vitro methods and acute animal preparations (I I , 14,24). Using chronically catheterized fetal lambs, fetal intestinal glucose and fructose absorption, lactase, maltase, and sucrase activity and fetal acid base status after gastrointestinally administering carbohydrates, were evaluated. It was found that lamb fetuses in the last third of gestation readily absorb intraduodenally administered glucose and fructose. They have considerable intestinal lactase activity, but no functional maltase or sucrase activity. The increase in fetal blood glucose concentration that occurs after glucose and lactose feeding is accompanied by a drop in pH and a rise in circulating lactate. No decrease in pH accompanies the increase in fructose concentration that occurs after fructose feeding. MATERIALS AND METHODS ANIMAL PREPARATIONThe authors used 12 third trimester pregnant ewes of known gestational age. All animals were fasted for 48 hr before surgical 10 preparation. Surgery was performed under low spinal anesthesia with 1% tetracaine hydrochloride. Polyvinyl catheters (French No. 8) were placed in the maternal femoral artery and vein. Sodium pentobarbital, 60 mg/ml, was given through the maternal vein for sedation as needed during the operation. A midline abdominal incision was made and the u...

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“…In infants, secretion outputs and enzyme activity levels mature at very different rates: gastric lipase activity already reaches adult levels by 3 months (Ménard et al, 1995), whereas pancreatic -amylase only does so after 3 years of age (Zoppi et al, 1972). In contrast, the small intestine of human infants is mature at birth and can handle the various nutrients (Shmerling, 1976). Despite the slow maturation of pancreatic amylase, most cooked starches are digested and absorbed almost completely (De Vizia et al, 1975).…”

Section: Digestion and Absorptionmentioning

confidence: 99%

Scientific Opinion on the appropriate age for introduction of complementary feeding of infants

Products¹

2009

EFSA Journal

169

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Following a request from the Commission, the Panel on Dietetic Products, Nutrition and Allergies was asked to deliver a scientific opinion on the appropriate age for the introduction of complementary food for infants in the EU. Many European countries have adopted the WHO recommendation for the duration of exclusive breastfeeding for 6 months, whilst other countries recommend the introduction of complementary feeding between 4 and 6 months. The Panel agrees with WHO and other authoritative national and international bodies that breastmilk is the preferred food for infants, but the focus in this opinion are the factors which determine the appropriate age for the introduction of complementary food into infants" diets. The Panel has evaluated predominantly studies in breast-fed healthy infants born at term for indicators of an appropriate age at which to introduce complementary food irrespective of existing recommendations on breast-feeding duration and on exclusivity of breast-feeding. The Panel has focussed its evaluation on data from developed countries. On the basis of present knowledge, the Panel concludes that the introduction of complementary food into the diet of healthy term infants in the EU between the age of 4 and 6 months is safe and does not pose a risk for adverse health effects (both in the short-term, including infections and retarded or excessive weight gain, and possible long-term effects such as allergy and obesity). Consistent with these conclusions, presently available data on the risk of celiac disease and type 1 diabetes mellitus support also the timing of the introduction of gluten containing food (preferably while still breast-feeding) not later than 6 months of age. Exclusive breast-feeding provides adequate nutrition up to 6 months of age for the majority of infants, while some infants may need complementary foods before 6 months (but not before 4 months) in addition to breast-feeding in order to support optimal growth and development. SUMMARYFollowing a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies was asked to deliver a scientific opinion on the appropriate age for the introduction of complementary food for infants in the EU.The background of the request is an inconsistency within the EU legislation and between the EU legislation and the relevant Codex Standard. The EU legislation (Article 8 of Directive 2006/125/EC) has been based on the opinions of the Scientific Committee for Food on weaning foods (EC, 1989 and) and provides for the following mandatory labelling: 'the stated age shall not be less than four months for any product'. In contrast to this, the labelling provisions in Directive 2006/141/EC concerning follow-on formula require the label to bear a statement saying that it is suitable only for infants over the age of six months. Furthermore, the Codex Standard for processed cereal-based foods for infants and young children (Section 8.6.4) states that 'The label shall indicate clearly from which age the product is recommended for...

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Development of Digestive and Absorptive Function in the Human Fetus

Cited by 11 publications

References 16 publications

Sudden Fetal Death Associated with Both Duodenal Atresia and Umbilical Cord Ulcer: A Case Report and Review

Sudden Fetal Death Associated with Both Duodenal Atresia and Umbilical Cord Ulcer: A Case Report and Review

Digestion and Absorption of Carbohydrates by the Fetal Lamb In Utero

Scientific Opinion on the appropriate age for introduction of complementary feeding of infants

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