Department of Neonatology, University Children's Hospital Tübingen, Calwerstr, 7, Tuebingen 72076, Germany.
BMC Pediatr. 2013 Nov 4;13:178. doi: 10.1186/1471-2431-13-178.
Fortified human milk may not meet all nutritional needs of very preterm infants. Early transition from complementary parenteral nutrition to full enteral feeds might further impair in-hospital growth. We aimed to investigate the impact of the cumulative intake of fortified human milk on early postnatal growth in a cohort of very low birth weight infants after early transition to full enteral feeds.
Retrospective single-centre observational study. Data are presented as median (interquartile range).
N = 206 very preterm infants were analysed (gestational age at birth 27.6 (25.6-29.6) weeks, birth weight 915 (668-1170) g). Full enteral feeds were established at postnatal day 8 (6-10) and adequate postnatal growth was achieved (difference in standard deviation score for weight from birth to discharge -0.105(-0.603 - -0.323)). Standard deviation score for weight from birth to day 28 decreased more in infants with a cumulative human milk intake > 75% of all enteral feeds (-0.64(-1.08 - -0.34)) compared to those with < 25% human milk intake (-0.41(-0.7 - -0.17); p = 0.017). At discharge, a trend towards poorer weight gain with higher proportions of human milk intake persisted. In contrast, we observed no significant difference for head circumference growth.
Our current standardized fortification of human milk may not adequately support early postnatal growth.
强化人乳可能无法满足极早产儿的所有营养需求。从补充性肠外营养向完全肠内喂养的早期过渡可能会进一步损害住院期间的生长。我们旨在研究在早期过渡到完全肠内喂养后，非常低出生体重儿中强化人乳的累积摄入量对早期产后生长的影响。
回顾性单中心观察性研究。数据以中位数（四分位距）表示。
共分析了 206 例极早产儿（出生胎龄 27.6（25.6-29.6）周，出生体重 915（668-1170）g）。在生后第 8 天（6-10 天）建立完全肠内喂养，并实现了适当的产后生长（从出生到出院时体重的标准差评分差值-0.105（-0.603- -0.323））。从出生到第 28 天，累积人乳摄入量>75%的婴儿体重的标准差评分下降更明显（-0.64（-1.08- -0.34）），而累积人乳摄入量<25%的婴儿体重的标准差评分下降更明显（-0.41（-0.7- -0.17）；p=0.017）。出院时，随着人乳摄入量比例的增加，体重增加趋势仍较差。相比之下，我们观察到头围生长没有显著差异。
我们目前对人乳的标准化强化可能无法充分支持早期产后生长。
