ABSTRACT. We determined metabolic responses after enteric galactose alimentation in 5-to 7-day-old newborn rats fasted for 24 h. The glycemic response was attenuated after enteric galactose feeding compared with the response after enteric glucose-fed rat pups. l4 C radioactivity in blood from galactose-fed pups was reduced as counts in blood galactose were lower than counts in blood glucose in glucose-fed pups. Nonetheless within 15 min, [I4 Cj from galactose appeared in blood glucose suggesting rapid conversion of galactose to glucose. The plasma insulin response was also attenuated after galactose feeding compared with the insulin response after enteric glucose. Hepatic glycogen content increased rapidly after enteric galactose feeding and was higher than after glucose feeding at 60, 120, and 180 min. Significant glycogen synthesis after oral glucose was delayed and occurred at 240 min. Carbon radioactivity in glycogen was higher in galactose fed pups between 15 and 360 min of the study. Serial determination of hepatic metabolites revealed an increase of galactose-1-phosphate levels after oral galactose at 240 and 300 min and a transient decline of ATP at 15 min. Other hepatic metabolites did not demonstrate significant differences between the two groups. These data suggest that hepatic glycogen synthesis is more rapid and occurs sooner after galactose than after glucose alimentation in previously fasted newborn rats. Galactose may enter a more direct pathway for neonatal hepatic glycogen synthesis. The relatively delayed entry of glucose label into hepatic glycogen and the delay of net glycogen synthesis after oral glucose suggest that glucose entry is not direct and may require further metabolism before incorporation into glycogen. Although galactose may replenish fasting neonatal hepatic glycogen content faster than glucose, there is concern over the elevated hepatic galactose-1-phosphate levels and the transient decline of ATP. (Pediatr Res 24: 302-307,1988) Abbreviations UDP-glucose, uridine diphosphate glucose PCA, perchloric acid Galactose is an important hexose source during the neonatal period. Galactose represents 50% of calories derived from carbohydrates among newborn mammals fed lactose-containing milk (I). In addition to serving as a substrate for oxidative metabolism and gluconeogenesis, galactose may also be a major