Does thermoregulatory feeding occur in newborn infants? A novel view of the role of brown adipose tissue thermogenesis in control of food intake.

The physiological significance of the extensive deposits of brown adipose tissue (BAT) in newborn human infants has been the subject of much experimentation and discussion. Because of its large thermogenic capacity, its function has usually been viewed as preparing the infant for producing heat in response to cold exposure at birth. Newborn infants are indeed capable of precise thermoregulation for a limited time over a rather limited range of ambient temperatures, from thermoneutrality (32-34 degrees C) down to common "room" temperatures (24-28 degrees C). During such mild "cold-exposure", in response to a decrease in their skin temperature, their sympathetic nervous system activity increases, and they can more than double their resting metabolic rate, principally by thermogenesis in their BAT. This review puts forward an entirely new role for BAT thermogenesis in the cyclic feeding pattern of newborn infants during their first months of life. BAT thermogenesis is proposed to be an integral element in a physiological thermoregulatory feeding control mechanism in which extended periods of very gradual cooling are interspersed with episodes of increased sympathetic nervous system activity, increased heating via BAT thermogenesis, arousal, and feeding. The cry with which the baby attracts its mother's attention is an integral part of the mechanism, as is the nutritive suckling reflex and the behavior of the mother. Initiation of feeding is attributed to a transient dip in blood glucose concentration that is due to stimulation of glucose utilization in the BAT. Termination of feeding is attributed to the high temperature brought about by the stimulated BAT thermogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)