Immature intestinal motility, digestion and defense
functions
Peristalsis is impaired in preterm infants until approximately
32 weeks of gestation13; impaired peristalsis not
only allows an increased carbohydrate load from enteral
feeding to serve as a bacterial substrate, but also prolongs
the exposure of the gut to bacterial antigens, thereby
inducing an inflammatory response.12
Preterm neonates usually have a relative lactase insufficiency.
14 Ingested lactose may be fermented into short
chain fatty acid (SCFA) and absorbed. Overproduction or
accumulation of SCFAs in the proximal colon, and/or distal
ileum, may play a role in the pathogenesis of NEC14; a study
also disclosed that maltodextrin maldigestion induces
NEC.15 Impaired lactose and maltodextrin digestion,
coupled with delayed transit time, could expose an immature
gut to injury