Maia Claudia, Brandão Railson, Roncalli Angelo, Maranhão Hélcio
Department of Pediatrics, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
J Matern Fetal Neonatal Med. 2011 Jun;24(6):774-7. doi: 10.3109/14767058.2010.520046. Epub 2011 Apr 7.
To identify the inpatient maternal and neonatal factors associated to the weaning of very low birth weight (VLBW) infants.
One hundred nineteen VLBW (<1500 g) infants were monitored from July 2005 through August 2006, from birth to the first ambulatory visit after maternity discharge. This maternity unit uses the Kangaroo Method and the Baby Friendly Hospital Initiative. Out of 119 VLBW infants monitored until discharge, 88 (75%) returned to the facility, 22 (25%) were on exclusive breastfeeding (EB), and 66 (75%) were weaned (partial breastfeeding or formula feeding).
Univariate analysis found an association between weaning and lower birth weight, longer stays in the neonatal intensive care unit (NICU), and longer hospitalization times, in addition to more prolonged enteral feeding and birth weight recovery period. Logistic regression showed length of NICU stay as being the main determinant of weaning.
The negative repercussion on EB of an extended stay in the NICU is a significant challenge for health professionals to provide more adequate nutrition to VLBW infants.
确定与极低出生体重(VLBW)婴儿断奶相关的住院产妇和新生儿因素。
对2005年7月至2006年8月期间出生的119例极低出生体重(<1500 g)婴儿进行监测,从出生至产妇出院后的首次门诊就诊。该产科病房采用袋鼠式护理法和爱婴医院倡议。在119例监测至出院的极低出生体重婴儿中,88例(75%)返回该机构,22例(25%)进行纯母乳喂养(EB),66例(75%)断奶(部分母乳喂养或配方奶喂养)。
单因素分析发现断奶与较低出生体重、在新生儿重症监护病房(NICU)停留时间更长、住院时间更长有关,此外还有更长的肠内喂养和出生体重恢复期。逻辑回归显示NICU停留时间是断奶的主要决定因素。
在NICU长时间停留对纯母乳喂养产生的负面影响,是卫生专业人员为极低出生体重婴儿提供更充足营养的一项重大挑战。