Preparing food for the tiniest of tummies

A simple change to the delivery system for intravenous nutrition could have a life-or-death impact on the survival rates of premature babies, a study has found.

Premature babies, born between 26 and 31 weeks of gestation, need to be fed intravenously due to the immaturity of their digestive system and their high nutritional requirements during their first days of life, as well as to prevent serious potential complications. Parenteral nutrition is essential to the babies’ survival because it provides them with vital nutrients like proteins, fat and glucose, and enables them to develop just as foetuses of their age would do in their mother’s womb.

However, exposing this type of food preparation to light generates oxidants which the premature infant’s immature defences cannot fight.

“The photo-excited vitamins B2 and ‘electron donors’ such as vitamin C, amino acids and lipids all interact in the multivitamin solution and generate oxidants,” explained Jean-Claude Lavoie, lead author of the study, which was published in the Journal of Parenteral and Enteral Nutrition. “This creates an oxidative stress which damages and kills newborn cells.”

The researchers at CHU Sainte-Justine and the University of Montreal have shown that shielding parenteral nutrition from light significantly decreases such an interaction, but the solution has to be shielded from the moment it is prepared in the pharmacy all the way through to infusion on the ward, including all bags, tubing and syringes through which it passes.

To reach these conclusions, researchers ran a meta-analysis of studies reporting the outcome of photo-protected parenteral nutrition on preterm infants. The mortality rates of 800 infants were analysed. A 50% reduction in mortality rates was reported, with male infants reported to be half as resistant to oxidative stress.

The team is about to launch a clinical trial to assess the efficacy of an end-to-end photo-protected delivery system that would be easy to implement in clinical settings.

Image credit: ©iStockphoto.com/Mark Goddard