Riskin Arieh, Bader David
Department of Neonatology, Bnai Zion Medical Center, Haifa, Israel.
Harefuah. 2003 Mar;142(3):217-22, 237, 236.
Nutrition for preterm babies is aimed at achieving expected intrauterine growth and accretion of nutrients. Early trophic feedings should be started as soon as possible for gastrointestinal priming. Mother's (breast) milk is the best food for preterm babies. Its advantages are in host defence, nutritional components and suitability for gut absorption, as well as its psychological and developmental value. The limitations of human milk for preterm babies, mainly in protein and minerals, can be compensated for by using powdered human milk fortifier. Sucking skills usually mature around 34 weeks, corrected gestational age. Thus, small preemies are initially fed by orogastric tubes, meaning that expressed breast milk is used. Support of lactation in mothers of preemies mandates protection of the mother and child bonding process and early skin to skin contact ("kangeroo care"). Methods for storage of expressed breast milk and the recommended length of storage are discussed. Milk bank mandates pasteurization and freezing of the donors' milk. Most of the nutritional and immunological advantages of human milk are preserved after such treatments. Cytomegalovirus (CMV) infections in preterm infants, that were acquired from mother's expressed breast milk, are not uncommon, and require further attention.
早产儿营养旨在实现预期的宫内生长和营养物质蓄积。应尽早开始早期微量喂养以促进胃肠道启动。母乳是早产儿的最佳食物。其优势在于宿主防御、营养成分、对肠道吸收的适宜性以及心理和发育价值。早产儿母乳的局限性主要在于蛋白质和矿物质,可通过使用母乳强化剂粉来弥补。吸吮技能通常在矫正胎龄34周左右成熟。因此,小早产儿最初通过口胃管喂养,即使用挤出的母乳。对早产儿母亲的泌乳支持要求保护母婴联结过程并尽早进行皮肤接触(“袋鼠式护理”)。文中讨论了挤出母乳的储存方法及推荐的储存时长。母乳库要求对捐赠者的乳汁进行巴氏杀菌和冷冻。经过此类处理后,母乳的大部分营养和免疫优势得以保留。早产儿通过母亲挤出的母乳感染巨细胞病毒(CMV)并不罕见,需要进一步关注。