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对家庭成员进行教育,以支持早产婴儿的固体食物断奶和营养。

Education of family members to support weaning to solids and nutrition in infants born preterm.

作者信息

Elfzzani Zenab, Kwok T'ng Chang, Ojha Shalini, Dorling Jon

机构信息

Academic Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham, UK.

出版信息

Cochrane Database Syst Rev. 2019 Feb 21;2(2):CD012240. doi: 10.1002/14651858.CD012240.pub2.

Abstract

BACKGROUND

Weaning refers to the period of introduction of solid food to complement breast milk or formula milk. Preterm infants are known to acquire extrauterine growth restriction by the time of discharge from neonatal units. Hence, the postdischarge and weaning period are crucial for optimal growth. Optimisation of nutrition during weaning may have long-term impacts on outcomes in preterm infants. Family members of preterm infants may require nutrition education to promote ideal nutrition practices surrounding weaning in preterm infants who are at high risk of nutritional deficit.

OBJECTIVES

To investigate the role of nutrition education of family members in supporting weaning in preterm infants with respect to their growth and neurodevelopment compared with conventional management.

SEARCH METHODS

We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 5), MEDLINE via PubMed (1966 to 26 June 2018), Embase (1980 to 26 June 2018), and CINAHL (1982 to 26 June 2018). We also searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials (RCTs) and quasi-RCTs.

SELECTION CRITERIA

RCTs and quasi-RCTs were eligible for inclusion if they examined the effects of nutrition education of family members as compared to conventional management for weaning of preterm infants up to one year of corrected gestational age. We defined prematurity as less than 37 completed weeks of gestation.

DATA COLLECTION AND ANALYSIS

At least two review authors independently screened potential studies for inclusion and planned to identify, extract data, and assess the quality of eligible studies. We resolved any differences in opinion through discussion with a third review author and consensus among all three review authors.

MAIN RESULTS

No eligible trials looking at the impact of nutrition education of family members in weaning of preterm infants fulfilled the inclusion criteria of this systematic review. Two studies investigating the ideal timing for weaning in premature infants reported conflicting results, AUTHORS' CONCLUSIONS: We were unable to assess the impact of nutrition education of family members in weaning of preterm infants as there were no eligible studies. This may be due to the lack of evidence to determine the ideal weaning strategies for preterm infants with regards to the time of initiating weaning and type of solids to introduce. Trials are needed to assess the many aspects of infant weaning in preterm infants. Long-term neurodevelopment and metabolic outcomes should also be assessed in addition to growth parameters.

摘要

背景

断奶是指引入固体食物以补充母乳或配方奶的时期。众所周知,早产儿在从新生儿病房出院时会出现宫外生长受限。因此,出院后和断奶期对于最佳生长至关重要。断奶期间营养的优化可能对早产儿的结局产生长期影响。早产儿的家庭成员可能需要接受营养教育,以促进对有营养缺乏高风险的早产儿断奶进行理想的营养实践。

目的

与传统管理相比,研究家庭成员的营养教育在支持早产儿断奶方面对其生长和神经发育的作用。

检索方法

我们使用Cochrane新生儿组的标准检索策略,检索Cochrane对照试验中心注册库(CENTRAL 2018年第5期)、通过PubMed检索MEDLINE(1966年至2018年6月26日)、Embase(1980年至2018年6月26日)和CINAHL(1982年至2018年6月26日)。我们还检索了临床试验数据库、会议论文集以及检索到的文章的参考文献列表,以查找随机对照试验(RCT)和半随机对照试验。

选择标准

如果RCT和半随机对照试验研究了与传统管理相比,家庭成员的营养教育对校正胎龄达一岁的早产儿断奶的影响,则 eligible for inclusion。我们将早产定义为妊娠少于37足周。

数据收集与分析

至少两名综述作者独立筛选潜在纳入研究,并计划识别、提取数据并评估 eligible studies 的质量。我们通过与第三位综述作者讨论并在所有三位综述作者之间达成共识来解决任何意见分歧。

主要结果

没有 eligible trials 研究家庭成员的营养教育对早产儿断奶的影响符合本系统综述的纳入标准。两项研究早产儿断奶理想时机的研究报告了相互矛盾的结果。

作者结论

由于没有 eligible studies,我们无法评估家庭成员的营养教育对早产儿断奶的影响。这可能是由于缺乏证据来确定早产儿断奶的理想策略,包括开始断奶的时间和引入的固体食物类型。需要进行试验来评估早产儿断奶的多个方面。除生长参数外,还应评估长期神经发育和代谢结局。

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