A new neonatal gastro-intestinal physiology-and pyloric stenosis of infancy a hypothesis

Abstract

The outside world carries many dangers for the new-born baby especially in primitive societies. One danger undoubtedly is the risk of serious early enteric infections. Neonatal gastric acid is the principal defense.

This author proposes that this acid defense is increased in two main ways;

1. An immediate temporary acidity created by maternal gastrin transfer during spontaneous labor.

2. A progressively rising acidity which culminates in a temporary peak acidity at approximately 3 weeks and is due to a late maturation of the negative feed-back between gastrin and gastric acidity.

The author contends that there is an immature negative-feed-back between neonatal gastrin and gastric acidity at birth which matures around 3 weeks of life. Until maturity, both gastrin and acid secretion rise without restraint.

In this way rising gastrin will stimulate acid secretion as well as enhance the development of gastric parietal cells to allow them, after feed-back matures, to independently provide an acid defense.

One consequence of this new physiology is that it allows us to simply explain why pyloric stenosis of infancy occurs--the most common and hitherto unexplainable cause of milk vomiting in the neonate.