O'Connor Deborah L, Ewaschuk Julia B, Unger Sharon
aDepartment of Nutritional Sciences bDepartment of Paediatrics and Neonatology, University of Toronto cPhysiology and Experimental Medicine Program, The Hospital for Sick Children, Toronto dDepartment of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton eDepartment of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.
Curr Opin Clin Nutr Metab Care. 2015 May;18(3):269-75. doi: 10.1097/MCO.0000000000000160.
Recent findings substantiate that the optimal method of nourishing preterm, very low birth weight infants (VLBW, born <1500 g) is through appropriately nutrient-enriched human milk, which is frequently provided as pasteurized donor milk. The availability of donor milk for VLBW infants during initial hospitalization continues to increase with the launch of new milk banks in North America. The majority of North American neonatal ICUs now have written policies governing the provision of donor milk. The purpose of this review is to summarize recent evidence regarding the risks and benefits of pasteurization of human milk and outcomes associated with its provision to VLBW preterm infants.
Studies investigating the impact of collection, storage and pasteurization on the bacteriostatic, immunologic and nutritional aspects of human milk continue to be published, generally revealing a partial, but not complete reduction in bioactivity. Risk of contamination of pasteurized donor human milk with pathogenic agents is mitigated through pasteurization. New pasteurization methods aiming to maintain the safety of pooled human milk while better preserving bioactivity are under investigation.
Provision of a human milk-derived diet to preterm VLBW infants is associated with improved outcomes.
近期研究结果证实，喂养早产极低出生体重儿（VLBW，出生体重<1500克）的最佳方法是通过营养成分适当强化的母乳，通常以巴氏杀菌的捐赠母乳形式提供。随着北美新母乳库的设立，VLBW婴儿在初次住院期间可获得的捐赠母乳量持续增加。北美大多数新生儿重症监护病房现在都有关于提供捐赠母乳的书面政策。本综述的目的是总结近期关于母乳巴氏杀菌的风险和益处以及向VLBW早产婴儿提供母乳相关结局的证据。
关于母乳采集、储存和巴氏杀菌对母乳抑菌、免疫和营养方面影响的研究不断发表，总体显示生物活性部分但未完全降低。巴氏杀菌可降低巴氏杀菌捐赠母乳被病原体污染的风险。旨在在更好地保存生物活性的同时保持混合母乳安全性的新巴氏杀菌方法正在研究中。
为早产VLBW婴儿提供基于母乳的饮食与改善结局相关。
