Background: Preterm infants show delayed development of motor function after birth. This may relate to functional immaturity of many organs, including the gut and brain. Using pigs as model for preterm infants, we hypothesized that early initiation of enteral feeding stimulates both gut growth and neonatal physical activity.
Methods:In experiment 1, preterm and term pigs were fed parenteral nutrition (PN) or PN plus bovine colostrum (BC, 16-64 ml/kg/d enterally) for 5 d. In experiment 2, preterm pigs were fed PN+BC or PN+formula for 5 d. In experiment 3, preterm pigs were fed BC, formula, or human milk (HM) for 10 d. Incubator home cage activity (HCA) was quantified by continuous camera recordings. results: Preterm birth was associated with reduced intestinal weight and HCA (experiment 1), and BC or formula supplementation increased intestinal weights and HCA (experiments 1+2). Enteral BC and HM feeding increased HCA, intestinal weights, and necrotizing enteritis resistance, relative to formula (experiment 3). conclusion: Preterm pigs show decreased physical activity, and the first enteral feeds diet dependently stimulate both gut growth and physical activity. The effects may arise from maturation of digestive, metabolic, and neurological functions, including gut serotonin production, by the first enteral feeds and milk bioactive factors.P reterm infants are a high-risk patient population with a variety of developmental complications, including delayed neurodevelopment and a high incidence of brain insults. Even when newborn preterm infants show no clinically observable brain defects, it is common to observe that such infants exhibit slower postnatal development of motor skills, compared with term infants. Even at term-corrected age, the brains in preterm infants may show compromised gray matter volume and altered developmental trajectory (1), probably explaining delayed neonatal arousal (2,3) and immature neuromuscular function and brain electroencephalography (4). In more longterm studies, preterm infants have shown reduced postural complexity (5) and lowered motor function (6), potentially persisting until school age (7), or even into adulthood (8). Thus, early impairment of physical locomotion in preterm infants may have long-term consequences.There is rapidly increasing evidence of functional links among the gastrointestinal tract (GIT), the diet, and the brain, especially in early life (9). Growth rate and nutrient intakes in early life may affect later neuromuscular and cognitive outcomes, but the mechanisms are largely unknown (10). Much focus has been devoted to the possible role of the lipid fraction of milk, but firm evidence for diet effects are lacking, not only in infants (11) but also in various animal models (12). In addition to the direct effects of nutrients and dietary factors on neurodevelopmental endpoints, indirect effects may arise from links between the early diet on gut growth, enteric nervous system, signaling molecules like serotonin (5-HT), and/ or gut microbiota. Studies in mice show...