Fontana Camilla, Menis Camilla, Pesenti Nicola, Passera Sofia, Liotto Nadia, Mosca Fabio, Roggero Paola, Fumagalli Monica
NICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via della Commenda 12, 20122 Milano, Italy.
NICU, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via della Commenda 12, 20122 Milano, Italy.
Early Hum Dev. 2018 Jun;121:15-20. doi: 10.1016/j.earlhumdev.2018.04.016. Epub 2018 May 3.
Although highly beneficial, human milk feeding is challenging in preterm infants due to adverse NICU factors for the infant and mother.
To investigate the effects of an early intervention in promoting infant's human milk feeding and acquisition of full oral feeding.
This study is part of a RCT. We included preterm infants born between 25 and 29 weeks of gestational age (GA) without severe morbidities, and their parents. Infants were randomized to either receive early intervention (EI) or standard care (SC). EI included PremieStart and parental training to promote infant massage and visual attention according to a detailed protocol. SC, in line with NICU protocols, included Kangaroo Mother Care. The time of acquisition of full oral feeding and human milk consumption at discharge were recorded.
Seventy preterm (EI n = 34, SC n = 36) infants were enrolled. Thirteen were excluded according to the protocol. Fifty-seven (EI n = 29, SC n = 28) infants were evaluated at discharge. The two groups were comparable for parent and infant characteristics. A significantly higher rate of infants fed with any human milk was observed in the EI group (75.9%) compared with the SC group (32.1%) (p = 0.001), and EI infants were four times more likely to be fed exclusively with human milk. Full oral feeding was achieved almost one week earlier in EI infants (mean postmenstrual age 36.8 ± 1.6 vs 37.9 ± 2.4 weeks in EI vs SC, p = 0.04).
Early interventions promoting mother self-efficacy and involvement in multisensory stimulation have beneficial effects on human milk feeding in preterm infants.
尽管母乳喂养益处显著，但由于新生儿重症监护病房（NICU）对婴儿和母亲存在不利因素，母乳喂养对早产儿来说具有挑战性。
探讨早期干预对促进婴儿母乳喂养及实现完全经口喂养的效果。
本研究是一项随机对照试验（RCT）的一部分。我们纳入了胎龄在25至29周之间且无严重疾病的早产儿及其父母。将婴儿随机分为接受早期干预（EI）组或标准护理（SC）组。EI包括PremieStart以及根据详细方案进行的促进婴儿按摩和视觉注意力的家长培训。SC按照NICU方案，包括袋鼠式护理。记录完全经口喂养的时间以及出院时的母乳摄入量。
共纳入70例早产儿（EI组n = 34，SC组n = 36）。根据方案排除13例。57例（EI组n = 29，SC组n = 28）婴儿在出院时接受评估。两组在父母和婴儿特征方面具有可比性。与SC组（32.1%）相比，EI组中接受任何母乳喂养的婴儿比例显著更高（75.9%）（p = 0.001），且EI组婴儿纯母乳喂养的可能性高出四倍。EI组婴儿实现完全经口喂养的时间几乎早一周（EI组与SC组的平均月经后年龄分别为36.8±1.6周和37.9±2.4周，p = 0.04）。
促进母亲自我效能感并参与多感官刺激的早期干预对早产儿母乳喂养具有有益效果。
