Objective: To study changes of plasma motilin concentration and it's effect on enteral nutrition in premature infants.

Methods: The plasma motilin concentration of 72 premature infants was measured within 12 hours after birth before enteral feeding and on day 3 and 7 of life by using radioimmunoassay. Sixteen full-term neonates were enrolled as controls.

Results: (1) The plasma concentrations of motilin in premature infants before enteral feeding after birth and on day 3 and 7 were 198.65 +/- 58.42 ng/L, 248.83 +/- 56.00 ng/L, and 376.77 +/- 139.46 ng/L, respectively, which were significantly lower than those in the control group (300.33 +/- 67.15 ng/L, 334.26 +/- 83.81 ng/L, 510.64 +/- 179.85 ng/L) (P < 0.001 or < 0.01). There was positive correlation between the concentration and gestational age, age in day and the volume of milk. On day 7 the level of motilin was higher than the pre-enteral feeding level of the full term control group. (2) The plasma motilin concentration in feeding un-tolerated premature infants group was lower than that in the normal group, especially on day 3 of life (P < 0.05). (3) Early enteral feeding could improve the plasma motilin levels, gastrointestinal motility and nutrition tolerance in premature infants.

Conclusions: The gastrointestinal functions of premature infants are adaptable to enteral nutrition. Early enteral feeding (including minimal enteral nutrition and non-nutritive sucking) can promote adaptive rapid growth and development of intestine.

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