Quitadamo Pasqua Anna, Palumbo Giuseppina, Cianti Liliana, Napolitano Matteo Luigi, Coviello Ciro, Lurdo Paola, Copetti Massimiliano, Gentile Maria Assunta, Cristalli Pierpaolo
BLUD, Fondazione IRCCS Casa Sollievo della Sofferenza, UO TIN-Neonatologia, San Giovanni Rotondo, Italy.
Int J Pediatr. 2018 Dec 2;2018:3628952. doi: 10.1155/2018/3628952. eCollection 2018.
The breast milk is the gold standard food for the feeding of the premature baby: it is the natural way to provide excellent nutritional, immunological, and biological nutriment so as to facilitate a healthy growth and the development of the infants. When the breast milk is not available, the alternative is represented by the donated milk. The mothers of premature infants are important opportunity if we consider the fact that they could devote some milk both because they provide a food which is closer to the needs of the vulnerable category of newborns and because it is, for the mothers, a way to overcome the detachment and the psychological trauma of a premature birth. There are no data on this kind of donation. The aim of the study is to evaluate the contribution of the milk donation to the HMB of CSS by women who gave birth to premature infants of gestational age <35 weeks and to analyze the macronutrient composition of the "preterm" donated milk. The CSS HMB has recruited 659 donors totalling 2236 liters of donated milk over a period of 7 years. 38 donors (5.7%) gave birth to a gestational age <35 weeks. Almost 20% of the donated milk comes from mothers of premature babies and this is a very important fact because it shows the huge potential belonging to this category of mothers. Taking into account the parameter regarding the birth weight, it was found that VLBW mothers contributed for 56% to preterm donation while ELBW mothers contributed for 41%. By evaluating the variable gestational age, about 40% of the average total donation derives from mothers who gave birth before the 25 weeks, while a contribution of 46% is attributable to the category of newborns with a GA between 25 and 32 weeks. Besides, some other exceptional examples can be outlined. Regarding the correlation analysis DM resulted in negative correlation with GA weeks (r=-0.31, p=0.058) and with BW g (r=-0.30, p=0.068) achieving values which are very close to the significance. The comparison between the donor volume averages of the preterm and full-term groups is statistically significant. The composition data are in line with the literature: there is an increase by 18 % in the protein component of the milk deriving from the mothers of the premature infants; the gap in carbohydrates is less significant (5-6%) and the gap in calories is similarly low being only 2% higher than the single donor milk and 11% more than the pooled milk. The data on the lipids line up to single donor term milk, while it grows by 24% compared to the pooled one. The study shows that even at very low or extreme gestational age it is possible to obtain an appropriate production of breast milk. This awareness becomes a fundamental starting point for the activation in a standardized way of all the strategies of promotion and support of food that have proven effective with the HM in NICU.
这是提供优质营养、免疫和生物养分以促进婴儿健康成长和发育的自然方式。当无法获得母乳时，捐赠母乳是替代选择。如果考虑到早产母亲可以提供一些母乳这一事实，她们就成为了重要的资源，这既是因为她们提供的食物更接近新生儿这一弱势群体的需求，也是因为对母亲来说，这是一种克服早产带来的分离感和心理创伤的方式。目前尚无关于此类捐赠的相关数据。本研究的目的是评估孕周<35周的早产产妇捐赠母乳对某儿童医院母乳库（CSS）的贡献，并分析“早产”捐赠母乳的宏量营养素组成。该儿童医院母乳库在7年时间里招募了659名捐赠者，共获得2236升捐赠母乳。38名捐赠者（5.7%）的孕周<35周。近20%的捐赠母乳来自早产母亲，这是一个非常重要的事实，因为它显示了这类母亲的巨大潜力。考虑到出生体重参数，极低出生体重（VLBW）母亲对早产捐赠的贡献为56%，而超低出生体重（ELBW）母亲的贡献为41%。通过评估孕周变量，约40%的平均总捐赠母乳来自25周前分娩的母亲，而46%的贡献来自孕周在25至32周之间的新生儿类别。此外，还可以列举一些其他特殊例子。关于相关性分析，捐赠母乳量（DM）与孕周数（r=-0.31，p=0.058）和出生体重（r=-0.30，p=0.068）呈负相关，其值非常接近显著性水平。早产组和足月组捐赠者平均捐赠量的比较具有统计学意义。成分数据与文献一致：早产母亲的母乳中蛋白质成分增加了18%；碳水化合物的差距较小（5 - 6%），热量差距同样较小，仅比单个捐赠者母乳高2%，比混合母乳高11%。脂质数据与单个捐赠者足月母乳一致，而与混合母乳相比增加了24%。该研究表明，即使在孕周非常低或极低的情况下，也有可能获得适量的母乳分泌。这种认识成为以标准化方式启动所有已被证明在新生儿重症监护病房（NICU）对母乳有效的促进和支持喂养策略的基本出发点。
