Department of Paediatrics, Division of Neonatology, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.
Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada.
Nutrients. 2020 Feb 24;12(2):589. doi: 10.3390/nu12020589.
Mother's own milk (MOM) improves in-hospital outcomes for preterm infants. If unavailable, donor milk (DM) is often substituted. It is unclear if DM vs. formula to supplement MOM is associated with improved in-hospital outcomes in term/late preterm surgical infants with gastroschisis or intestinal atresia.
This retrospective study included infants born ≥33 weeks gestational age (GA) with a birth weight of >1500 g who were admitted to a quaternary neonatal intensive care unit (NICU). Using Chi square and Mann-Whitney u testing, we compared hospital outcomes (length of stay, parenteral nutrition and central line days) before and after a clinical practice change to offer DM instead of formula in this surgical population.
Baseline characteristics were similar between eras for the 140 infants (median GA 37 weeks). Fewer infants in DM era were receiving formula at discharge (50.0% vs. 31.4%, = 0.03). In sub-analyses including only small bowel atresia and gastroschisis infants, the median length of stay (35 vs. 25, < 0.01) and the central line days (28 vs. 20, < 0.01) were lower in the DM era.
In this retrospective study, offering DM instead of formula was associated with less formula feeding at discharge, and in infants with gastroschisis or small bowel atresia, shorter length of stay and central line days.
母乳（MOM）可改善早产儿的住院治疗效果。如果无法获得母乳，则通常会使用捐赠奶（DM）替代。但 DM 与配方奶补充 MOM 是否会改善患有先天性胃壁肌层缺损或肠闭锁的足月/晚期早产儿手术患儿的住院治疗效果尚不清楚。
本回顾性研究纳入了出生胎龄≥33 周且出生体重＞1500g、入住四级新生儿重症监护病房（NICU）的婴儿。我们采用卡方检验和曼-惠特尼 U 检验，比较了在临床实践改变后（即该手术人群中提供 DM 而非配方奶），该时间段内患儿的住院治疗结局（住院时间、肠外营养和中心静脉置管天数）的差异。
在 140 名婴儿（中位胎龄 37 周）中，两个时期的基线特征相似。DM 时期的患儿在出院时接受配方奶的比例较低（50.0% vs. 31.4%， = 0.03）。在仅包括肠闭锁和先天性胃壁肌层缺损患儿的亚组分析中，DM 时期的患儿住院时间中位数（35 天 vs. 25 天， ＜0.01）和中心静脉置管天数中位数（28 天 vs. 20 天， ＜0.01）更低。
在本回顾性研究中，与提供配方奶相比，提供 DM 与出院时减少配方奶喂养相关，并且在患有先天性胃壁肌层缺损或肠闭锁的患儿中，DM 还可缩短住院时间和中心静脉置管天数。
