Brown Jennifer Valeska Elli, Walsh Verena, McGuire William
Centre for Reviews and Dissemination, University of York, York, UK.
Cochrane Database Syst Rev. 2019 Aug 12;8(8):CD002972. doi: 10.1002/14651858.CD002972.pub3.
Artificial formula can be manipulated to contain higher amounts of macro-nutrients than maternal breast milk but breast milk confers important immuno-nutritional advantages for preterm or low birth weight (LBW) infants.
To determine the effect of feeding preterm or LBW infants with formula compared with maternal breast milk on growth and developmental outcomes.
We used the standard strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 9), and Ovid MEDLINE, Ovid Embase, Ovid Maternity & Infant Care Database, and CINAHL to October 2018. We searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles.
Randomised or quasi-randomised controlled trials that compared feeding preterm or low birth weight infants with formula versus maternal breast milk.
Two review authors planned independently to assess trial eligibility and risk of bias, and extract data. We planned to analyse treatment effects as described in the individual trials and report risk ratios and risk differences for dichotomous data, and mean differences for continuous data, with 95% confidence intervals. We planned to use a fixed-effect model in meta-analyses and to explore potential causes of heterogeneity in subgroup analyses. We planned to use the GRADE approach to assess the certainty of evidence.
We did not identify any eligible trials.
AUTHORS' CONCLUSIONS: There are no trials of formula versus maternal breast milk for feeding preterm or low birth weight infants. Such trials are unlikely to be conducted because of the difficulty of allocating an alternative form of nutrition to an infant whose mother wishes to feed with her own breast milk. Maternal breast milk remains the default choice of enteral nutrition because observational studies, and meta-analyses of trials comparing feeding with formula versus donor breast milk, suggest that feeding with breast milk has major immuno-nutritional advantages for preterm or low birth weight infants.
人工配方奶可调配成含有比母乳更高含量的宏量营养素，但母乳为早产或低出生体重婴儿带来重要的免疫营养优势。
确定与母乳相比，用配方奶喂养早产或低出生体重婴儿对生长和发育结局的影响。
我们采用Cochrane新生儿组的标准策略，检索Cochrane对照试验中心注册库（CENTRAL 2018年第9期）、Ovid MEDLINE、Ovid Embase、Ovid母婴护理数据库以及截至2018年10月的CINAHL。我们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。
比较用配方奶与母乳喂养早产或低出生体重婴儿的随机或半随机对照试验。
两位综述作者独立计划评估试验的合格性和偏倚风险，并提取数据。我们计划按照各试验中的描述分析治疗效果，并报告二分数据的风险比和风险差异，以及连续数据的均值差异，并给出95%置信区间。我们计划在Meta分析中使用固定效应模型，并在亚组分析中探索异质性的潜在原因。我们计划使用GRADE方法评估证据的确定性。
我们未识别出任何符合条件的试验。
尚无关于用配方奶与母乳喂养早产或低出生体重婴儿的试验。由于难以给希望母乳喂养的婴儿分配另一种营养形式，此类试验不太可能进行。母乳仍然是肠内营养的默认选择，因为观察性研究以及比较配方奶与捐赠母乳喂养的试验的Meta分析表明，母乳喂养对早产或低出生体重婴儿具有主要的免疫营养优势。
