Tshamala Didier, Pelecanos Anita, Davies Mark W
Neonatal Intensive Care Unit, Mater Mother's Newborn Care Services, Mater Mothers' Hospital, Brisbane, Queensland, Australia.
Statistics Unit, Queensland Institute of Medical Research, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2018 Sep;54(9):1016-1022. doi: 10.1111/jpc.14062. Epub 2018 May 28.
To determine the proportion of very preterm infants who were exclusively fed breast milk at the time of discharge home, before and after the availability of pasteurised donor human milk (PDHM).
This was an observational retrospective cohort study with historical comparison, comparing two cohorts (<32 weeks gestational age or very low birthweight) before and after the availability of donor human milk. The main explanatory variable was the PDHM cohort: pre-PDHM or post-PDHM. The primary dichotomous outcome variable was defined as whether the baby was being fed with breast milk only at the time of discharge home, compared with those fed with artificial formula alone or mixed feeding (artificial formula and breast milk).
There were 1088 babies in the pre-PDHM cohort and 330 in the post-PDHM cohort (total n = 1418). Following the introduction of PDHM, 56% (185/330) were exclusively fed breast milk at the time of hospital discharge and 57% (620/1088) in the pre-PDHM cohort. The availability of PDHM is not a significant predictor of feeding outcome upon discharge (P = 0.45) when adjusted for maternal age, log-transformed post-natal age at discharge home and any congenital abnormality.
The availability of donor human milk in our unit is not associated with a decrease in the number of very preterm infants receiving mother's own breast milk at time of discharge home. Other factors that positively impact the successful establishment of breastfeeding in preterm babies were older maternal age, the absence of any congenital abnormality and a shorter duration of hospital stay.
确定在巴氏杀菌供体人乳(PDHM)可用前后,出院回家时纯母乳喂养的极早产儿比例。
这是一项采用历史对照的观察性回顾性队列研究,比较了供体人乳可用前后的两个队列(胎龄<32周或出生体重极低)。主要解释变量是PDHM队列:PDHM之前或之后。主要二分结局变量定义为与仅人工喂养或混合喂养(人工配方奶和母乳)的婴儿相比,婴儿出院回家时是否仅接受母乳喂养。
PDHM之前的队列中有1088名婴儿,PDHM之后的队列中有330名婴儿(总数n = 1418)。引入PDHM后,56%(185/330)的婴儿在出院时纯母乳喂养,PDHM之前的队列中这一比例为57%(620/1088)。在对产妇年龄、出院时经对数转换的产后年龄以及任何先天性异常进行调整后,PDHM的可用性不是出院时喂养结局的显著预测因素(P = 0.45)。
我们单位供体人乳的可用性与出院回家时接受母亲自己母乳的极早产儿数量减少无关。对早产儿成功建立母乳喂养有积极影响的其他因素包括产妇年龄较大、无任何先天性异常以及住院时间较短。