Review: Is Fetal Enteral Nutrition Important for Normal Gastrointestinal Growth?: A Discussion

Abstract

Long-term total parenteral nutrition results in atrophy of small intestinal structure and function. Maintenance or re-establishment of enteral nutrition can prevent or redress this loss. Paradoxically, the fetus develops in a total parenteral nutrition environment, but at the same time must achieve appropriate levels of gastrointestinal maturation in readiness for enteral feeding soon after birth. The fetus swallows large amounts of fluid during life in utero and growth is arrested if fetal ingestion is impaired. It is possible therefore that enteral nutrition provided by fetal swallowing is just as important in ensuring normal gastrointestinal homeostasis and growth in the fetus as it is in the adult.

Glucocorticoids and the preparation for life after birth: are there long-term consequences of the life insurance?

“…Growth factors present in the milk can then complete the process of gastrointestinal maturation, particularly in the distal regions, via both luminal and systemic mechanisms (Trahair & Sangild, 1997). The effects of cortisol on the secretion of gastrin and other gut peptides indicate that it may also have an important role in the onset of the local and endocrine control mechanisms characteristic of postnatal gastrointestinal function (Trahair, 1993). Certainly, gastrointestinal function is poor in animals delivered prematurely before the final cortisol surge (Moog, 1979).…”

Fetal Intestinal Obstruction Induces Alteration of Enteric Nervous System Development in Human Intestinal Atresia

“…Twelve fetal intestines from 8 to 35 wk gestation (8,10,11,13,15,18,21,25,30,32,34, and 35 wk) were obtained from medical elective termination of pregnancies with the permission of the local ethical committee of Hôpital Necker Enfants-Malades. They were from jejunal and ileal portions of the gut.…”

“…Intestinal motility appears early at 16 wk gestation (7) in fetal life and likely supports the nutritional function of the gut before birth (8,9). Intestinal atresia, by interrupting antenatal gut peristalsis, may hamper the normal development of ENS.…”

Mucosal morphogenesis and cytodifferentiation in fetal porcine small intestine

“…After this time, it begins to decrease and is undetectable in enterocytes from proximal small intestine (Colony, 1983). Additionally, Trahair (1993) suggested that the apical endosome-lysosome complex may be involved in uptake of hormones, growth factors, and other macromolecules from fluid swallowed during gestation. Similar to human duodenal enterocytes, porcine duodenal enterocytes lack elements of either system close to parturition.…”