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早产儿每日个体化强化母乳喂养的生长获益。

Growth Benefits of Own Mother's Milk in Preterm Infants Fed Daily Individualized Fortified Human Milk.

机构信息

Department of Neonatology, University of Liège, CHU and CHR Liège, 4000 Liège, Belgium.

Human Milk Bank of CHR Liège, 4000 Liège, Belgium.

出版信息

Nutrients. 2019 Apr 3;11(4):772. doi: 10.3390/nu11040772.

Abstract

The influence of types of human milk (HM)-raw own mother's milk (OMM), pasteurized OMM, and donor milk (DM)-was evaluated for growth in premature infants fed exclusively HM with controlled nutritional intakes using daily individualized HM fortification (IHMF). Growth and nutritional intakes were prospectively collected in preterm infants (<32 weeks) fed IHMF and compared in infants fed predominantly (≥75%) OMM and DM. The influence of HM types (raw OMM, pasteurized OMM, and DM) on growth were also evaluated in the whole population. One-hundred and one preterm infants (birth weight 970 ± 255 g, gestational age 27.8 ± 1.9 weeks) were included. Energy (143 ± 8 vs. 141 ± 6 kcal/kg/day; = 0.15) and protein intakes (4.17 ± 0.15 vs. 4.15 ± 0.14 g/kg/day; = 0.51) were similar in both groups. Infants receiving predominantly OMM ( = 37), gained significantly more weight (19.8 ± 2.0 vs. 18.2 ± 2.2 g/kg/day; = 0.002) and length (1.17 ± 0.26 vs. 0.99 ± 0.36 cm/week; = 0.020) than those fed predominantly DM ( = 33). Stepwise multivariate analysis ( = 101) suggests that raw OMM was the major determinant of growth, contributing 22.7% of weight gain. Length gain was also related to OMM (raw + pasteurized) intakes, explaining 4.0% of length gain. In conclusion, at daily controlled similar protein and energy intakes, OMM had significant beneficial effects on weight and length versus DM in VLBW infants. This difference could be partially explained by the use of raw OMM.

摘要

研究人员评估了人乳(HM)类型(初乳、巴氏消毒乳和捐赠乳)对接受个体化人乳强化(IHMF)、完全接受 HM 喂养的早产儿生长的影响。研究人员前瞻性收集了接受 IHMF 喂养的早产儿(<32 周)的生长和营养摄入量,并将其与主要接受(≥75%)OMM 和 DM 喂养的婴儿进行了比较。研究人员还评估了 HM 类型(初乳、巴氏消毒乳和 DM)对整个人群生长的影响。共纳入 101 例早产儿(出生体重 970 ± 255 g,胎龄 27.8 ± 1.9 周)。两组的能量(143 ± 8 与 141 ± 6 kcal/kg/day; = 0.15)和蛋白质摄入量(4.17 ± 0.15 与 4.15 ± 0.14 g/kg/day; = 0.51)相似。主要接受 OMM( = 37)喂养的婴儿体重增加明显更多(19.8 ± 2.0 与 18.2 ± 2.2 g/kg/day; = 0.002)和身长增长更快(1.17 ± 0.26 与 0.99 ± 0.36 cm/week; = 0.020),而主要接受 DM( = 33)喂养的婴儿体重和身长增长较少。逐步多元分析( = 101)提示,初乳是人乳促进生长的主要决定因素,对体重增长的贡献为 22.7%。身长增长也与人乳(初乳+巴氏消毒乳)摄入量有关,占身长增长的 4.0%。总之,在每日接受相似的蛋白质和能量摄入时,与 DM 相比,OMM 对 VLBW 婴儿的体重和身长增长有显著的有益影响。这种差异部分可以通过使用初乳来解释。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f84/6521225/89feeaae5d57/nutrients-11-00772-g001.jpg

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