Straňák Zbyněk, Feyereislova Simona, Černá Marcela, Kollárová Jana, Feyereisl Jaroslav
Third Faculty of Medicine, Charles University, Prague, Czech Republic.
Department of Neonatology, Institute for the Care of Mother and Child, Prague, Czech Republic.
PLoS One. 2016 Feb 26;11(2):e0150053. doi: 10.1371/journal.pone.0150053. eCollection 2016.
Breastfeeding is known to reduce infant morbidity and improve well-being. Nevertheless, breastfeeding rates remain low despite public health efforts. Our study aims to investigate the effect of controlled limited formula usage during birth hospitalisation on breastfeeding, using the primary hypothesis that early limited formula feeds in infants with early weight loss will not adversely affect the rate of exclusive or any breastfeeding as measured at discharge, 3 and 6 months of age.
We randomly assigned 104 healthy term infants, 24 to 48 hours old, with ≥ 5% loss of birth weight to controlled limited formula (CLF) intervention (10 ml formula by syringe after each breastfeeding, discontinued at onset of lactation) or control group (standard approach, SA). Groups were compared for demographic data and breastfeeding rates at discharge, 3 months and 6 months of age (p-values adjusted for multiple testing).
Fifty newborns were analysed in CLF and 50 in SA group. There were no differences in demographic data or clinical characteristics between groups. We found no evidence of difference between treatment groups in the rates of exclusive as well as any breastfeeding at discharge (p-value 0.2 and >0.99 respectively), 3 months (p-value 0.12 and 0.10) and 6 months of infants' age (p-value 0.45 and 0.34 respectively). The percentage weight loss during hospitalisation was significantly higher in the SA group (7.3% in CLF group, 8.4% in SA group, p = 0.002).
The study shows that controlled limited formula use does not have an adverse effect on rates of breastfeeding in the short and long term. Larger studies are needed to confirm a possible potential in controlled limited formula use to support establishing breastfeeding and to help to improve the rates of breastfeeding overall.
ISRCTN registry ISRCTN61915183.
众所周知，母乳喂养可降低婴儿发病率并改善其健康状况。然而，尽管公共卫生部门做出了努力，母乳喂养率仍然很低。我们的研究旨在调查出生住院期间控制有限使用配方奶对母乳喂养的影响，主要假设是出生体重早期下降的婴儿早期有限使用配方奶不会对出院时、3个月和6个月时测量的纯母乳喂养率或任何母乳喂养率产生不利影响。
我们将104名出生24至48小时、出生体重下降≥5%的健康足月儿随机分为控制有限配方奶（CLF）干预组（每次母乳喂养后用注射器喂10毫升配方奶，泌乳开始后停止）或对照组（标准方法，SA）。比较两组的人口统计学数据以及出院时、3个月和6个月时的母乳喂养率（p值经多重检验校正）。
CLF组分析了50名新生儿，SA组分析了50名新生儿。两组之间的人口统计学数据或临床特征没有差异。我们发现，治疗组在出院时（p值分别为0.2和>0.99）、3个月时（p值分别为0.12和0.10）以及6个月时（p值分别为0.45和0.34）的纯母乳喂养率和任何母乳喂养率均无差异。SA组住院期间体重下降百分比显著更高（CLF组为7.3%，SA组为8.4%，p = 0.002）。
该研究表明，控制有限使用配方奶在短期和长期内对母乳喂养率没有不利影响。需要更大规模的研究来证实控制有限使用配方奶在支持建立母乳喂养和帮助提高总体母乳喂养率方面可能存在的潜力。
国际标准随机对照试验编号ISRCTN61915183。
