Gwinnett Neonatology, P.C., Gwinnett Medical Center, Lawrenceville, GA, USA.
J Perinatol. 2012 Jul;32(7):525-31. doi: 10.1038/jp.2011.140. Epub 2011 Sep 29.
To determine whether human milk fortification from the time of the first feeding significantly improves weight gain and bone mineral status in infants of <31 weeks estimated gestational age as compared with delayed or standard human milk fortification.
This was a retrospective pre-post design. In all, 95 infants born at <31 weeks estimated gestational age were compared. There were 53 infants in the early fortification group (EFG) and 42 infants in the delayed fortification group (DFG). They were compared with regard to weight gain at 34 weeks postmenstrual age (PMA), and their serum levels of calcium, phosphorus and alkaline phosphatase levels were compared as an indicator of bone mineral status. The practice change of fortifying all human milk given to preterm infants at <34 weeks PMA commenced in June 2009. The usual practice of fortification took place once an infant had reached a feeding volume of 50 to 100 ml kg(-1) per day. The new practice fortified all human milk with a powdered human milk fortifier to 24 calories per ounce, starting with the first feeding, no matter how small the volume.
There were no differences in weight gain between the EFG and the DFG. The group that received fortification from the time of the first feeding were significantly less likely to have alkaline phosphatase levels >500 U l(-1) from 33 weeks PMA onward. There was no incidence of feeding intolerance with early fortification.
Fortification of human milk from the time of the first feeding does not affect weight gain at 34 weeks PMA, but is related to a lower incidence of elevated alkaline phosphate levels and does not cause feeding intolerance.
与延迟或标准人乳强化相比，从首次喂养开始强化人乳是否显著改善胎龄<31 周的婴儿的体重增加和骨矿物质状况。
这是一项回顾性前后设计。共有 95 名胎龄<31 周的婴儿参与研究。其中 53 名婴儿为早期强化组（EFG），42 名婴儿为延迟强化组（DFG）。比较两组在 34 周校正胎龄（PMA）时的体重增长情况，并比较两组血清钙、磷和碱性磷酸酶水平作为骨矿物质状况的指标。2009 年 6 月开始对所有胎龄<34 周 PMA 的早产儿进行强化人乳喂养。通常的强化方法是在婴儿达到每天 50-100ml/kg 的喂养量后进行。新的强化方法是从第一次喂养开始，用粉末状人乳强化剂将所有人乳强化至每盎司 24 卡路里，无论喂养量有多小。
EFG 和 DFG 之间的体重增长没有差异。从 33 周 PMA 开始，接受首次喂养强化的婴儿碱性磷酸酶水平>500U/L 的发生率明显较低。早期强化没有出现喂养不耐受。
从首次喂养开始强化人乳不会影响 34 周 PMA 时的体重增长，但与碱性磷酸酶水平升高的发生率较低有关，并且不会引起喂养不耐受。
