**5.2 Feeding and immature GI function**

Premature GIT is relatively deficient in digestive functions and peristaltic motility in addition to immune responses [28]. Dysfunctional gastric emptying and increased gastric pH add to gut barrier disruption and epithelial permeability [4, 29–31]. Aggressive feeding with peristaltic dysmotility leads to stasis of intraluminal contents and intestinal dilatation, which may further impair epithelial barrier (EB). These, in concurrence with microbial dysbiosis, result in abnormal signal transduction across the EB with consequent inflammation, apoptosis, and necrosis. The balance between the pro-inflammatory and anti-inflammatory signaling is affected with an inappropriate response to pathogenic microorganisms.
