在美国一家三级新生儿重症监护病房(NICU),实施捐赠母乳项目与极低出生体重儿更多食用母亲自身母乳相关。
Implementation of a Donor Milk Program Is Associated with Greater Consumption of Mothers' Own Milk among VLBW Infants in a US, Level 3 NICU.
作者信息
Parker Margaret G K, Burnham Laura, Mao Wenyang, Philipp Barbara L, Merewood Anne
机构信息
Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
出版信息
J Hum Lact. 2016 May;32(2):221-8. doi: 10.1177/0890334415598305. Epub 2015 Aug 4.
BACKGROUND
It is unclear whether use of donor milk (DM) changes the provision of mothers' own milk (MOM) to very low birth weight (VLBW) infants in the neonatal intensive care unit (NICU).
OBJECTIVES
To determine whether (1) the rates of any MOM and human milk consumption at feeding initiation and discharge and (2) the proportion of VLBW infants who stopped consuming any MOM and human milk during hospitalization changed in the 2 years after versus before implementation of a DM program in a US, inner-city, level 3 NICU.
METHODS
We studied VLBW infants admitted to Boston Medical Center in the 2 years before (n = 74) and after (n = 80) implementation of a DM program (June 2011). We used multivariable logistic regression to compare milk consumption at feeding initiation and discharge and Cox proportional hazards to compare the proportion of infants that stopped consuming milk during the hospitalization pre and post our DM program.
RESULTS
After adjustment for maternal race, age, insurance, delivery type, gestational age, and birth weight, we found a 6.0-fold increased odds (95% CI, 2.0-17.7) of consuming MOM at discharge and a 49% reduction in the cessation of MOM consumption during hospitalization (hazard ratio [HR], 0.51; 95% CI, 0.28-0.93) in the 2 years after versus before our DM program.
CONCLUSION
Implementation of a DM program was associated with greater consumption of MOM throughout hospitalization and at discharge among VLBW infants. Implementation of DM programs may augment support of mothers to provide breast milk in level 3 NICUs.
背景
在新生儿重症监护病房(NICU)中,使用捐赠母乳(DM)是否会改变极低出生体重(VLBW)婴儿母亲自身母乳(MOM)的供应量尚不清楚。
目的
确定在美国一个市中心三级NICU实施DM项目后的2年里,(1)开始喂养时和出院时任何MOM及母乳的摄入量,以及(2)住院期间停止食用任何MOM及母乳的VLBW婴儿比例与实施该项目之前相比是否发生了变化。
方法
我们研究了波士顿医疗中心在实施DM项目(2011年6月)之前(n = 74)和之后(n = 80)两年内收治的VLBW婴儿。我们使用多变量逻辑回归来比较开始喂养时和出院时的母乳摄入量,并使用Cox比例风险模型来比较DM项目实施前后住院期间停止食用母乳的婴儿比例。
结果
在对母亲的种族、年龄、保险、分娩类型、孕周和出生体重进行调整后,我们发现与实施DM项目之前相比,实施该项目后的2年里,出院时食用MOM的几率增加了6.0倍(95%可信区间,2.0 - 17.7),住院期间停止食用MOM的比例降低了49%(风险比[HR],0.51;95%可信区间,0.28 - 0.93)。
结论
实施DM项目与VLBW婴儿在整个住院期间及出院时更多地食用MOM有关。在三级NICU实施DM项目可能会增强对母亲提供母乳的支持。