de Halleux Virginie, Pieltain Catherine, Senterre Thibault, Rigo Jacques
Department of Neonatology, University of Liège, CHU of Liège, CHR de la Citadelle, Liège, Belgium.
Department of Neonatology, University of Liège, CHU of Liège, CHR de la Citadelle, Liège, Belgium.
Semin Fetal Neonatal Med. 2017 Feb;22(1):23-29. doi: 10.1016/j.siny.2016.08.003. Epub 2016 Sep 16.
Own mother's milk is the first choice in feeding preterm infants and provides multiple short- and long-term benefits. When it is unavailable, donor human milk is recommended as the first alternative. Donor milk undergoes processing (i.e. pasteurization) to reduce bacteriological and viral contaminants but influences its bioactive properties with potentially fewer benefits than raw milk. However, there is no clinical evidence of health benefit of raw compared to pasteurized human milk, and donor milk maintains documented advantages compared to formula. Nutrient content of donor and own mother's milk fails to meet the requirements of preterm infants. Adequate fortification is necessary to provide optimal growth. There are significant challenges in providing donor milk for premature infants; therefore, specific clinical guidelines for human milk banks and donor milk use in the neonatal intensive care unit should be applied and research should focus on innovative solutions to process human milk while preserving its immunological and nutritional components. In addition, milk banks are not the only instrument to collect, process and store donor milk but represent an excellent tool for breastfeeding promotion.
母乳是喂养早产儿的首选，具有多种短期和长期益处。若无法获得母乳，推荐捐赠母乳作为首选替代品。捐赠母乳需经过处理（如巴氏杀菌）以减少细菌和病毒污染物，但这会影响其生物活性，其益处可能比生乳少。然而，尚无临床证据表明生母乳比巴氏杀菌母乳对健康更有益，且与配方奶相比，捐赠母乳仍具有已记录的优势。捐赠母乳和母乳的营养成分无法满足早产儿的需求。进行充分强化以实现最佳生长是必要的。为早产儿提供捐赠母乳存在重大挑战；因此，应应用针对母乳库和新生儿重症监护病房使用捐赠母乳的具体临床指南，研究应侧重于在保留母乳免疫和营养成分的同时处理母乳的创新解决方案。此外，母乳库并非收集、处理和储存捐赠母乳的唯一手段，但却是促进母乳喂养的极佳工具。
