Background and aims In preterm infants, slow advancement of minimal enteral nutrition (MEN), combined with parenteral nutrition (PN), may be important to increase food tolerance and minimise the risk of necrotizing enterocolitis (NEC). We hypothesised that MEN for five days would increase gut growth and gut hormone release relative to total parenteral nutrition (TPN).
Methods Preterm and term piglets were delivered by caesarean section and fed TPN or PN+MEN (MEN: 0–64 mL bovine colostrum /kg/d) for five days. From day 5–26 all pigs were fed total enteral nutrition with milk-replacer. Pigs were euthanized at 0, 5 or 26 days of age, and gut weight, mucosal volume, L-cell density and plasma levels of GIP and GLP-2 were measured.
Results Body weight gain was markedly reduced in preterm vs. term (P < 0.01). Relative to TPN feeding, MEN for 5 days increased relative gut weight, mucosa volume and plasma GLP-2 and GIP in both preterm and term pigs (all P < 0.05). At 26 days of age, mucosa volume tended to be higher in preterm MEN versus preterm TPN (P = 0.11), whereas relative gut weight, L-cell density and plasma GLP-2 and GIP levels were similar between term/preterm and MEN/TPN.
Conclusion Despite the compromised growth in preterm pigs, the intestine is highly growth-responsive to MEN just after birth in both preterm and term pigs. The effects of MEN on gut dimensions and gut peptide release are minimal after few weeks of full enteral nutrition. MEN provision may be important for short term gut maturation in preterm infants.