Onset of feeding at birth--perinatal development of the hypothalamic mechanisms that induce appetite and feeding in the newborn.

Orexin-A and -B are hypothalamic peptides which, in the adult brain, are associated with arousal, increased vigilance, and the seeking and ingestion of food. Because the fetus is mostly asleep, and hunger is a physiological state unlikely to arise until birth, we hypothesized that orexigenic neurons in the lateral and dorso-medial hypothalamic areas (LHA, DMH) and their projections to the locus coeruleus (LC) would develop only near the time of birth. We therefore determined orexin expression in fetal sheep, where birth occurs over a tightly regulated interval of 146-148 days gestation. Immunohistochemistry was used to determine the presence and distribution of orexin-A positive fibres and cells at the level of the hypothalamus and LC in fetal (125-137 and 145+ days gestation age) and newborn sheep brains. Orexin was measured by radioimmunoassay in plasma samples taken from chronically catheterised fetal and newborn sheep, and in CSF taken from fetuses and lambs at postmortem. Orexin-A positive cells bodies were observed in the hypothalamus, and orexin-A fibres were found throughout all hypothalamic, thalamic, and brain stem regions of all the fetal and newborn brains examined. Orexin-A was present in plasma and CSF at similar concentrations in fetal and newborn sheep. The presence of orexin in hypothalamic neurons and CSF throughout late gestation suggests that orexinergic regulation of hunger, appetite and the sleep/wake cycle is inhibited, by mechanisms yet to be identified, until the time of parturition.