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UNSW Embryology

Normal Development - Postnatal Gastrointestinal Tract

© Dr Mark Hill (2008)

Acknowledgements

Introduction

This page is an introduction to postnatal gastrointestinal tract development. This nutritionally involves a change from prenatal placental vascular nutrition to postnatal oral colostrum/milk enteral nutrition (enteral = nutritient delivery as fluid into the gastrointestinal tract).

Early Embryonic GIT

These notes should be read in conjunction with the detailed page Milk Notes and an understanding of prenatal Gastrointesitnal Tract Development. The review article (abstract shown below) by Goldman in 2000 may provide a way of thinking about GIT and human milk.

Page Links: Introduction | Some Recent Findings | Lipid Signalling | Human Milk | References | Glossary

Some Recent Findings

Wang PY, Caspi L, Lam CK, Chari M, Li X, Light PE, Gutierrez-Juarez R, Ang M, Schwartz GJ, Lam TK. Upper intestinal lipids trigger a gut-brain-liver axis to regulate glucose production. Nature. 2008 Apr 9;

Lipid Signalling

Lipids present in the intestine leads to a reduction in nutrient intake. Recent research has shown that lipids present in the intestine can also regulate endogenous nutrient production. (Wang PY, etal., 2008)

Signalling pathway:

presence of ingested lipids

↓

intestinal lipid sensors

↓

signal to the brain

↓

liver

↓

reduction in endogenous glucose production

Links: Wang PY, etal., 2008

Insulin-like Growth Factors

insulin-like growth factors (IGFs) and IGF binding proteins (IGFBPs)

Some evidence to suggest that in preterm infants IGFBP-2 and IGF-II present in breast milk may have an important role in their early development.

Human Milk

"Human milk contains agents that affect the growth, development and functions of the epithelium, immune system or nervous system of the gastrointestinal tract. Some human and animal studies indicate that human milk affects the growth of intestinal villi, the development of intestinal disaccharidases, the permeability of the gastrointestinal tract and resistance to certain inflammatory/immune-mediated diseases. Moreover, one cytokine in human milk, interleukin (IL)-10, protects infant mice genetically deficient in IL-10 against an enterocolitis that resembles necrotizing enterocolitis (NEC) in human premature infants.

There are seven overlapping evolutionary strategies regarding the relationships between the functions of the mammary gland and the infant’s gastrointestinal tract as follows:

  1. certain immunologic agents in human milk compensate directly for developmental delays in those same agents in the recipient infant
  2. other agents in human milk do not compensate directly for developmental delays in the production of those same agents, but nevertheless protect the recipient
  3. agents in human milk enhance functions that are poorly expressed in the recipient
  4. agents in human milk change the physiologic state of the intestines from one adapted to intrauterine life to one suited to extrauterine life
  5. some agents in human milk prevent inflammation in the recipient’s gastrointestinal tract
  6. survival of human milk agents in the gastrointestinal tract is enhanced because of delayed production of pancreatic proteases and gastric acid by newborn infants, antiproteases and inhibitors of gastric acid production in human milk, inherent resistance of some human milk agents to proteolysis, and protective binding of other factors in human milk
  7. growth factors in human milk aid in establishing a commensal enteric microflora"

(Text from: Goldman AS. Modulation of the gastrointestinal tract of infants by human milk. Interfaces and interactions. An evolutionary perspective. J Nutr. 2000 Feb;130(2S Suppl):426S-431S. Review.)

Links: Milk

References

Links: Reviews | Articles | Online Textbooks | Search Textbooks | Search PubMed | Glossary

PubMed

Kent JC. How breastfeeding works. J Midwifery Womens Health. 2007 Nov-Dec;52(6):564-70. Review.

Oddy WH. The impact of breastmilk on infant and child health. Breastfeed Rev. 2002 Nov;10(3):5-18. Review

Field CJ. The immunological components of human milk and their effect on immune development in infants. J Nutr. 2005 Jan;135(1):1-4. Review.

Preterm Baby Nutrition

Klein CJ. Nutrient requirements for preterm infant formulas. J Nutr. 2002 Jun;132(6 Suppl 1):1395S-577S. Review.

Marriott LD, Foote KD. Advances in the nutrition of preterm infants. J R Soc Health. 2003 Sep;123(3):159-64. Review.

Its not just about Baby Nutrition

Zadik Z. Maternal nutrition, fetal weight, body composition and disease in later life. J Endocrinol Invest. 2003 Sep;26(9):941-5. Review.

Those helpful bacteria

Backhed F, Ley RE, Sonnenburg JL, Peterson DA, Gordon JI. Host-bacterial mutualism in the human intestine. Science. 2005 Mar 25;307(5717):1915-20. Review.

Hooper LV, Midtvedt T, Gordon JI. How host-microbial interactions shape the nutrient environment of the mammalian intestine. Annu Rev Nutr. 2002;22:283-307. Epub 2002 Apr 4. Review.

Kaper JB, Sperandio V. Bacterial cell-to-cell signaling in the gastrointestinal tract. Infect Immun. 2005 Jun;73(6):3197-209. Review.

Changes

Veereman-Wauters G. Neonatal gut development and postnatal adaptation. Eur J Pediatr. 1996 Aug;155(8):627-32. Review.

de Santa Barbara P, van den Brink GR, Roberts DJ. Development and differentiation of the intestinal epithelium. Cell Mol Life Sci. 2003 Jul;60(7):1322-32. Review.

Your gut has an endocrine function

Lee CS, Kaestner KH. Clinical endocrinology and metabolism. Development of gut endocrine cells. Best Pract Res Clin Endocrinol Metab. 2004 Dec;18(4):453-62. Review.

Articles

Wang PY, Caspi L, Lam CK, Chari M, Li X, Light PE, Gutierrez-Juarez R, Ang M, Schwartz GJ, Lam TK. Upper intestinal lipids trigger a gut-brain-liver axis to regulate glucose production. Nature. 2008 Apr 9;

Asensi MT, Martinez-Costa C, Buesa J. Anti-rotavirus Antibodies in Human Milk: Quantification and Neutralizing Activity. J Pediatr Gastroenterol Nutr. 2006 May;42(5):560-567. Teilum K, Hoch JC, Goffin V, Kinet S, Martial JA, Kragelund BB. Solution structure of human prolactin. J Mol Biol. 2005 Aug 26;351(4):810-23.

Search PubMed

Search April 2008 "postnatal gastrtointestinal tract development" 1,395 reference articles of which 64 were reviews.

Search PubMed: postnatal gastrointestinal tract development | human milk | breast feeding |

WWW Links

Australia ABC - Diet and nutrition

New Zealand Medsafe - Drug Safety in Lactation

USA American Society for Nutritional Sciences

WHO WHO Nutrition

Glossary of Terms

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