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高摄入量母乳并个体化补充矿物质和蛋白质对孕周<28周早产儿早期生长的影响

Effect of high volume intake of mother's milk with an individualized supplementation of minerals and protein on early growth of preterm infants <28 weeks of gestation.

作者信息

Doege Corinna, Bauer Jacqueline

机构信息

Department of Pediatrics, Division of Neonatology, University of Heidelberg, Im Neuenheimer Feld 150, 69120 Heidelberg, Germany.

出版信息

Clin Nutr. 2007 Oct;26(5):581-8. doi: 10.1016/j.clnu.2007.06.002. Epub 2007 Jul 25.

DOI:10.1016/j.clnu.2007.06.002
PMID:17655982
Abstract

OBJECTIVE

A prospective study was designed to evaluate the effects of high volume intake of mother's milk fortified (FMM) with an individualized supplementation of minerals and protein on tolerance, short-term somatic growth, serum concentrations of calcium, phosphorus, alkaline phosphatase, and total plasma protein in healthy preterm infants below 28 weeks of gestation.

METHODS

Sixty preterm infants were included in the FMM group, for having received >80% or more of the milk volume as their own mother's milk at 3 weeks of postnatal age to 38 weeks of corrected gestational age. This group was compared with 60 preterm infants fed exclusively preterm formula milk (PF). Intended fluid volume of the FMM group was approximately 200 and 150-170 mL/kg/d in the PF group. Mother's milk was supplemented with the goal of a daily protein intake of 3.5-4 g/kg/d. Phosphorus was supplemented from 15.5 to 31 mg per 100mL mother's milk.

RESULTS

Both feeding regimes were well tolerated. At the end of the study, nutritional management in both groups resulted in a body weight between the 25th and 50th percentiles of intrauterine growth expectations. Serum values of electrolytes, alkaline phosphatase, plasma protein, blood urea nitrogen, and urinary mineral excretion did not differ significantly between the two groups at study entry as well as at the end of the investigation.

CONCLUSIONS

Mother's milk fed at higher volumes with an individualized fortification of minerals and protein provides sufficient nutrients to allow adequate growth of preterm infants <28 weeks of gestation.

摘要

目的

设计一项前瞻性研究,以评估大量摄入强化了个性化矿物质和蛋白质补充剂的母乳(FMM)对妊娠28周以下健康早产儿的耐受性、短期身体生长、血清钙、磷、碱性磷酸酶和总血浆蛋白浓度的影响。

方法

FMM组纳入60例早产儿,这些早产儿在出生后3周龄至矫正胎龄38周期间,摄入的母乳量占总奶量的80%或更多。该组与60例仅喂养早产儿配方奶(PF)的早产儿进行比较。FMM组的目标液体摄入量约为200 mL/kg/d,PF组为150 - 170 mL/kg/d。母乳补充的目标是每日蛋白质摄入量为3.5 - 4 g/kg/d。每100 mL母乳中磷的补充量从15.5 mg增加到31 mg。

结果

两种喂养方式耐受性均良好。在研究结束时,两组的营养管理均使体重处于宫内生长预期的第25至50百分位之间。在研究开始时以及研究结束时,两组的电解质、碱性磷酸酶、血浆蛋白、血尿素氮血清值以及尿矿物质排泄均无显著差异。

结论

大量喂养并进行个性化矿物质和蛋白质强化的母乳可为妊娠<28周的早产儿提供足够的营养,以实现充分生长。

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