The Starving Newborn Baby

Wilkinson, A. W.

doi:10.1079/pns19690012

Cited by 5 publications

(3 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unlike the rat, the normal baby at term has a high body fat content (16% of body weight) and can survive prolonged starva tion without hypoglycemia [Wilkinson, 1969]. In contrast, the small for gestional age (SGA) newborn has a low body fat content at birth and develops hypoglycemia after a short fast [Cornblath and Schwartz, 1976], A defect in gluconeogenesis has been proposed to explain hypoglycemia in SGA babies (Haymond et al, 1974], and it has been shown that infusion of triglycerides into hy poglycemic SGA neonates raises their blood glucose levels [Mestyan et al.…”

Section: Importance O F Liver Fatty Acid Oxidation In the Regulation mentioning

confidence: 99%

Metabolic Adaptations to Change of Nutrition at Birth

Girard

1990

Neonatology

118

View full text Add to dashboard Cite

Birth represents a dramatic change of nutrition from a fetal diet rich in carbohydrates and poor in fat to a neonatal diet rich in fat and poor in carbohydrates. Gluconeogenesis and ketogenesis are absent or very low in the fetal liver when the mother is correctly fed, and these metabolic pathways emerge after birth to reach adult values after 24 h. Gluconeogenesis increases rapidly in the liver of the newborn in parallel with the appearance of phosphoenolpyruvate carboxykinase (PEPCK), the rate-limiting enzyme of this metabolic pathway. The rise in plasma glucagon, the fall in plasma insulin and the resulting increase in liver cAMP which occur immediately after birth are the factors which induce the activation of liver PEPCK gene transcription. The appearance of ketogenesis is also controlled by the changes of plasma insulin and glucagon that increase the capacity for liver fatty acid oxidation by decreasing lipogenesis and malonyl-CoA concentration, by reducing the sensitivity of carnitine palmitoyl-CoA I to the inhibitory influence of malonyl-CoA, and by activating hydroxymethylglutaryl-CoA synthase by desuccinylation. Once liver PEPCK has reached adult value, i.e. 12 h after birth, other factors are involved in the regulation of hepatic gluconeogenesis. Indeed, the supply of gluconeogenic substrates and of free fatty acid is of crucial importance to support a high rate of gluconeogenesis and to maintain normoglycemia in the newborn. In the liver, fatty acid oxidation provides essential co-factors (acetyl-CoA, NADH and ATP) to support gluconeogenesis, and in peripheral tissue fatty acid oxidation inhibits glucose oxidation and stimulates the production of gluconeogenic precursors (lactate, pyruvate and alanine). Similar mechanisms are operative in human newborn. A defective hepatic fatty acid oxidation is likely to explain the frequent hypoglycemia observed in small-for-date neonates. Administration of oral triglycerides is an efficient mean to prevent hypoglycemia in these newborns.

show abstract

Section: Importance O F Liver Fatty Acid Oxidation In the Regulation mentioning

confidence: 99%

Metabolic Adaptations to Change of Nutrition at Birth

Girard

1990

Neonatology

118

View full text Add to dashboard Cite

show abstract

“…Capsules have been reported to consist to more than 95% of water (SUTHERLAND 1972;WILKINSON 1959). Obviously such a high water content is apt to cause difficulties in the attempts to preserve capsular structures whenever fixation, dehydration, or staining is required in light and electron microscopy (KELLENBERGER 1987(KELLENBERGER , 1980.…”

Section: Introductionmentioning

confidence: 99%

Bacterial Capsules

1990

Current Topics in Microbiology and Immunology

View full text Add to dashboard Cite

“…Surgical operations in the neonate are nearly always accompanied by starvation which may be prolonged especially if the gastrointestinal tract is involved (32). In the human baby, depot fat accounts for 10 to 15% of body weight (31).…”

Section: Speculationmentioning

confidence: 99%

The Effects of Starvation and Surgical Injury on the Plasma Levels of Glucose, Free Fatty Acids, and Neutral Lipids in Newborn Babies Suffering from Various Congenital Anomalies

Elphick

Wilkinson

1981

Pediatr Res

View full text Add to dashboard Cite

SummaryBlood glucose, plasma free fatty acids (FFA), cholesterol, phospholipids, and triglycerides were measured in blood obtained by heel prick from 32 neonatal surgical patients suffering from various congenital malformations which prevented an adequate intake of milk. The result of almost complete starvation for up to 7 days was investigated and the effects of a surgical operation were studied in 12 of the babies. All the babies weighed more than 2 kg at birth.A surgical operation caused a rise in blood glucose concentration but a variable change in plasma concentration of FFA. Blood glucose returned to normal within 8 to 12 hr. The plasma concentrations of cholesterol and phospholipids did not change except in two babies in whom the concentration of both fell. Four to 24 hr after operation the plasma triglyceride level fell by an average of 25% but later rose.During starvation for 7 days, the blood glucose concentration was maintained within normal limits. Plasma FFA concentration normally rose during the first 2 days of life and was very high between days 3 and 5. Plasma triglyceride, cholesterol, phospholipids, and total esterified fatty acids also increased after birth. The results suggest that during starvation in the neonate there is rapid mobilisation of fat from adipose tissue stores and a reduction in the peripheral utilisation of glucose. There was no evidence to suggest any impairment of fat mobilisation or metabolism even --aftlh; starvation for 7 days. After surgical injury, these changes were accentuated because the rate of utilisation of fat was ereater 0 than that of mobilisation. SpeculationBabies of normal birthweight may be more able to cope with starvation and surgical injury than is generally realised.Measurements of the respiratory quotient of newborn babies indicate that perhaps as much as 80% of the energy requirement is derived from fat (2). Although carbohydrate is the main source of energy in the fetus. soon after birth and before feeding is started there is a rapid fall in glycogen reserves (27), and in the blood glucose concentration (5) and an increase of plasma free fatty acids (FFA) and ketone bodies (IS,19).Surgical operations in the neonate are nearly always accompanied by starvation which may be prolonged especially if the gastrointestinal tract is involved (32). In the human baby, depot fat accounts for 10 to 15% of body weight (31). and it may be the main source of energy during starvation soon after birth (12). 1Many regimes are used for the parenteral nutrition of newborn infants after operation, based on the use of glucose and other carbohydrates, amino acid solutions, and fat emulsions, but there is disagreement as to when and how such solutions should be used. In the present investigation, the plasma concentrations of glucose and lipids were measured in a group of neonatal surgical patients who were selected for study because either they had not been fed or had vomited most of the feeds they had been given. The purpose of this investigation was to determine how well t...

show abstract

The Starving Newborn Baby

Cited by 5 publications

References 5 publications

Metabolic Adaptations to Change of Nutrition at Birth

Metabolic Adaptations to Change of Nutrition at Birth

Bacterial Capsules

The Effects of Starvation and Surgical Injury on the Plasma Levels of Glucose, Free Fatty Acids, and Neutral Lipids in Newborn Babies Suffering from Various Congenital Anomalies

Contact Info

Product

Resources

About