Relationships between feeding and glucose concentrations in healthy term infants during the first five days after birth-the Glucose in Well Babies Study (GLOW).
Front Pediatr
; 11: 1147659, 2023.
Article
en En
| MEDLINE
| ID: mdl-37033167
ABSTRACT
Background:
The World Health Organization recommends breastfeeding be commenced as soon as possible after birth. Amongst other benefits, early feeding is expected to support the metabolic transition after birth, but effects on blood glucose concentrations are controversial. We sought to describe the changes in interstitial glucose concentrations after feedings over the first five postnatal days. Participants andMethods:
In healthy singleton term infants, all feeds were recorded using a smart phone app. Glucose concentrations were measured by blinded interstitial monitoring, calibrated by heel-prick capillary samples 2-4 times/d. Feeding sessions were included if a start and end time were recorded, and if the interval between the start of successive feeds was >90â min. The area under the glucose concentration curve (AUC) was calculated by trapezoidal addition from baseline (median of the 3 measurements before the beginning of the session). The maximum deviation (MD) was the greatest change in glucose concentration (positive or negative) from baseline to the next feeding session or 180â min, whichever came first. Data were analyzed using Stata V17 and are presented as mean (95% CI) in mmol/L.Results:
Data were available for 62 infants and 1,770 feedings. The glucose response to breastfeeding was not different from zero on day 1 [day 1 AUC 0.05 (-0.00, 0.10), MD 0.06 (-0.05, 0.16)], but increased thereafter (day 3 (AUC 0.23 (0.18, 0.28), MD 0.41 (0.32, 0.50), day 5 AUC 0.11 (0.06, 0.16), MD 0.28 (0.18, 0.37), p < 0.001 for age effect). Glucose response increased with increased duration of breastfeeding (<30â min AUC 0.06 (0.02,0.09), MD 0.12 (0.04,0.19), >30â min AUC 0.20 (0.16, 0.23) MD 0.37 (0.30, 0.44), p < 0.001 for duration effect) and this was observed even in the first 2 days (<30â min AUC-0.02 (-0.06, 0.03), MD -0.06 (-0.15, 0.03), >30â min AUC 0.12 (0.08, 0.16), MD 0.19 (0.11, 0.27), overall p < 0.001 for age x duration interaction). In feeding sessions that were not breastfeeding, the glucose response was greater after formula than after expressed human milk [AUC 0.29 (0.15, 0.29), MD 0.48 (-0.12, 0.61)], and greater after feed volumes >20â ml than <10â ml [20-30â ml AUC 0.19 (0.01, 0.27), MD 0.23 (-0.01, 0.46)].Conclusion:
The glucose response to feeding in the days after birth increases with postnatal age and duration of the feeding episode. Breastfeeding for <30â min has little effect on glucose concentrations in the first two days.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
Problema de salud:
2_cobertura_universal
Idioma:
En
Revista:
Front Pediatr
Año:
2023
Tipo del documento:
Article
País de afiliación:
Nueva Zelanda