Griffin Ian J, Cooke Richard J
USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA.
J Pediatr Gastroenterol Nutr. 2007 Dec;45 Suppl 3:S195-203. doi: 10.1097/01.mpg.0000302972.13739.64.
Growth failure in preterm infants remains extremely common despite advances in neonatal care. Many, or even a majority, leave the hospital with weights below the 10th centile for age. Because of this, the possibility of nutritional interventions to improve postdischarge growth has been considered. A variety of interventions have been tested in randomized controlled trials in formula-fed infants. Although the studies vary in design and in the intervention used, on balance the evidence supports the use of fortified formulas in formula-fed preterm infants after hospital discharge. Specially designed postdischarge formulas and preterm infant formulas seem equally efficacious. The situation for infants fed human milk is much less clear. Although the postdischarge growth in human milk-fed infants is not as good as in formula-fed infants, no interventions have been examined in human milk-fed infants in a randomized study, to our knowledge. We are unaware of any evidence that any of the commonly proposed nutritional interventions in human milk-fed infants after hospital discharge are either safe or efficacious. In the absence of such evidence, it seems prudent to avoid untested interventions in this population and to concentrate our efforts on the encouragement of breast-feeding after hospital discharge.
尽管新生儿护理取得了进展，但早产儿生长发育迟缓仍然极为常见。许多早产儿，甚至大多数早产儿出院时体重低于同龄儿的第10百分位数。因此，人们考虑通过营养干预来促进出院后生长发育的可能性。在配方奶喂养婴儿的随机对照试验中，已经对多种干预措施进行了测试。尽管这些研究在设计和所采用的干预措施上各不相同，但总体而言，证据支持出院后的配方奶喂养早产儿使用强化配方奶。专门设计的出院后配方奶和早产儿配方奶似乎同样有效。母乳喂养婴儿的情况则不太明确。据我们所知，虽然母乳喂养婴儿出院后的生长情况不如配方奶喂养婴儿，但尚未有针对母乳喂养婴儿的随机研究对干预措施进行过检验。我们也不知道有任何证据表明，出院后对母乳喂养婴儿普遍建议的任何营养干预措施是安全有效的。在缺乏此类证据的情况下，避免对这一人群采用未经检验的干预措施，并将努力集中在鼓励出院后母乳喂养上似乎是审慎之举。
