Jean

Quoting from: Akre J, Infant Feeding: The physiological basis, Supplement to
Vol 67 1989 of the Bulletin of the World Health Organization, page 56:
"The process of food digestion starts in the mouth;  during mastication
foods are mixed with saliva allowing the action of amylase to begin the
digestion of starches.  Although amylase has been found in infant saliva, no
digestion of carbohydrates takes place in the mouth or oesophagus during the
first months of life
"....It has been determined that infants born at term have approximately 10%
of adult amylase activity in their small intestine and this seems to be
mainly glucoamylase activity.  Present information indicates that pancreatic
amylase is not secreted during the first three months of life;  it has been
found to be present only at very low levels, or absent altogether, up to six
months of age.
"There is, however, some evidence that infants can digest starches before
three months of age.  This is probably due to the activity of glucoamylase,
which is not normally active at this time, but which is activated by the
presence and nature of the substance or substrate on which the enzyme acts.
It is also possible that pancreatic amylase could be produced as a reaction
to the presence of starches n the small intestine, althought this has not
been proved.  In any case, a process of adaptation is required for the young
infant to be able to digest starches.  This can take days or weeks and might
explain the frequency with which gastrointestinal disturbances, particularly
diarrhoea, are observed in small infants fed starch-containing foods.  It
has also been suggested that undigested starches may interfere with the
absorption of other nutrients and result in failure to thrive in infants fed
diets containing a large proportion of starches."

And with gratitude to Jim Akre for his kind gift of this book to me, which I
use again and again.

Pamela Morrison, IBCLC
Harare, Zimbabwe

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