Lindemann P C, Foshaugen I, Lindemann R
Neonatal Intensive Care Unit, Depart-ment of Paediatrics, Ullevål University Hospital, NO-0407 Oslo, Norway.
Arch Dis Child Fetal Neonatal Ed. 2004 Sep;89(5):F440-1. doi: 10.1136/adc.2003.046656.
OBJECTIVE: Breast milk is the most important nutrient to all newborn babies. If the mother's milk production is insufficient, it is important to provide donor breast milk without reduction of its immunologic and antimicrobial properties. Early use of breast milk to preterm infants has shown a reduced incidence of necrotising enterocolitis, a faster tolerance of enteral feeding, and a reduced need of parenteral nutrition. It is important to have milk from a CMV-IgG negative donor to VLBW infants considered immunocompromised. METHODS: Between January 1st and December 31st 2001, 69 women delivered 1.973 litres (mean 28.6 litres/woman/year). 73% had college education, were primipara, and with a mean age of 30.7 years. Those who smoked, used alcohol or any medications were refused as donors. They started to deliver approximately 7 weeks after having given birth and continued for a mean of 4 months. Each milk sample was tested for bacterial growth. Every donor was screened for HIV, CMV-IgG and hepatitis B/C before donating milk and thereafter every third month. RESULTS: 62.3% was CMV-IgG positive. Samples containing staphylococcus aureus, klebsialla-, enterobacter- and serratia-species or E. coli, and all samples containing > 10(4) cfu/ml were pasteurised. Overall, only 10.5% of the samples were pasteurised. CONCLUSION: It is possible and important to provide VLBW babies with fresh frozen unpasteurised CMV-IgG negative breast milk until their own mothers' milk production is sufficient.
目的:母乳是所有新生儿最重要的营养物质。如果母亲的乳汁分泌不足,提供具有免疫和抗菌特性且未降低的捐赠母乳很重要。对早产儿早期使用母乳已显示坏死性小肠结肠炎的发病率降低、对肠内喂养的耐受性更快以及肠外营养需求减少。对于被认为免疫功能低下的极低出生体重婴儿,提供来自巨细胞病毒IgG阴性捐赠者的母乳很重要。 方法:在2001年1月1日至12月31日期间,69名女性捐献了1973升母乳(平均每位女性每年28.6升)。73%的捐赠者受过大学教育,是初产妇,平均年龄为30.7岁。吸烟、饮酒或使用任何药物的女性被拒绝作为捐赠者。她们在分娩后约7周开始捐献,并持续平均4个月。对每个母乳样本进行细菌生长检测。每位捐赠者在捐献母乳前以及之后每三个月进行一次艾滋病毒、巨细胞病毒IgG和乙肝/丙肝筛查。 结果:62.3%的捐赠者巨细胞病毒IgG呈阳性。含有金黄色葡萄球菌、克雷伯菌属、肠杆菌属、沙雷菌属或大肠杆菌的样本,以及所有每毫升菌落形成单位>10⁴的样本都进行了巴氏消毒。总体而言,只有10.5%的样本进行了巴氏消毒。 结论:在极低出生体重婴儿自身母亲的乳汁分泌充足之前,为其提供新鲜冷冻的未巴氏消毒的巨细胞病毒IgG阴性母乳是可行且重要的。
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