Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA.
Department of Neonatology, Crouse Hospital, Syracuse, NY, USA.
J Perinatol. 2019 Jan;39(1):108-114. doi: 10.1038/s41372-018-0235-3. Epub 2018 Oct 5.
We examined the effect of two strategies to prevent necrotizing enterocolitis (NEC) in extremely low birth weight (ELBW) infants-adherence to a standardized feeding protocol and use of a hospital-based milk bank to provide exclusive preterm human milk feedings.
We conducted a single-center observational study from 2010 to 2015. Infants received preterm human milk, initially trophic feeds from days 7 to 14 after birth, followed by advancement of 15 mL/kg/day to reach a goal of 180 mL/kg/day. Fortification was used selectively for weight gain < 15 g/kg/day. We determined the incidence of NEC, other morbidities, and growth.
The cohort included 398 ELBW infants who survived to day 14 without congenital anomalies. Mean gestational age was 26.2 ± 1.9 weeks. Maternal milk was used as the sole feeding in 62% of infants; preterm donor milk was used solely or as supplement in 29%. Full feeds were reached at a median of 27 (IQR 23, 33) days. Four infants (1%) developed NEC.
Use of standardized feedings with a hospital-based milk bank is associated with an incidence of NEC lower than previously reported.
我们研究了两种预防极低出生体重（ELBW）婴儿坏死性小肠结肠炎（NEC）的策略的效果 - 遵循标准化喂养方案和使用医院内的母乳库提供纯早产儿母乳喂养。
我们进行了一项 2010 年至 2015 年的单中心观察性研究。婴儿接受早产儿母乳，最初在出生后 7 至 14 天给予营养性喂养，然后每天增加 15 毫升/公斤，以达到每天 180 毫升/公斤的目标。根据体重增加 < 15 克/公斤/天的情况选择性添加强化剂。我们确定了 NEC 的发生率、其他并发症和生长情况。
队列包括 398 名幸存至 14 天且无先天畸形的 ELBW 婴儿。平均胎龄为 26.2±1.9 周。母亲的母乳是 62%婴儿的唯一喂养来源；早产儿捐赠母乳单独或作为补充使用占 29%。中位数为 27（IQR 23，33）天达到全量喂养。4 名婴儿（1%）发生 NEC。
使用标准化喂养方案和医院内的母乳库与之前报道的 NEC 发生率较低相关。
