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供体人乳在早产儿以外人群中的使用:系统范围界定综述。

Donor Human Milk Use in Populations Other than the Preterm Infant: A Systematic Scoping Review.

机构信息

Department of Nutrition, University of North Carolina Greensboro, Greensboro, North Carolina, USA.

出版信息

Breastfeed Med. 2021 Jan;16(1):8-20. doi: 10.1089/bfm.2020.0286. Epub 2020 Nov 25.

Abstract

Exclusive breastfeeding is recommended for an infant's first 6 months of life. If unable to breastfeed, expressed breast milk, including donor human milk (DHM), is recommended for optimal nutrition. Benefits of DHM in preterm infants have been established by extensive research. However, less is known about DHM use in other populations. To conduct a scoping review of the literature regarding DHM use in populations other than preterm infants. PubMed and Clinicaltrials.gov were used to search for articles and clinical trials published between January 1, 2000 and February 29, 2020. In total, 182 articles and reports were identified and screened by 2 independent reviewers. Twenty-six articles met inclusion criteria and were reviewed. Studies were mostly observational in design and included infants born >35 weeks gestational age with health risks (9/26) and healthy infants (14/26). Most studies in infants with health risks (7/9) investigated clinical outcomes, with small, observational studies suggesting potential improvements in feeding tolerance and gastrointestinal health. Regarding healthy infants, no studies addressed growth, only one study measured clinical outcomes, and findings related to breastfeeding outcomes were conflicting. Over half of the studies reviewed (15/26) were not designed to establish a potential relationship between DHM use and relevant health-related outcomes. The current evidence of DHM use in populations other than preterm infants is limited by lack of direct health measures and infrequent use of randomized trials. More research is warranted to investigate clinical, growth, and breastfeeding outcomes.

摘要

建议婴儿在生命的头 6 个月进行纯母乳喂养。如果无法进行母乳喂养,则建议使用挤出的母乳,包括捐赠人母乳(DHM),以实现最佳营养。大量研究已经证实了 DHM 对早产儿的益处。然而,对于其他人群中使用 DHM 的情况了解较少。

旨在对除早产儿以外的其他人群中使用 DHM 的文献进行范围性综述。使用 PubMed 和 Clinicaltrials.gov 搜索了 2000 年 1 月 1 日至 2020 年 2 月 29 日期间发表的文章和临床试验。共确定了 182 篇文章和报告,并由 2 位独立审查员进行筛选。

符合纳入标准并进行了审查的有 26 篇文章。这些研究大多为观察性设计,包括患有健康风险的>35 周龄婴儿(9/26)和健康婴儿(14/26)。大多数患有健康风险的婴儿(7/9)的研究都调查了临床结局,小型观察性研究表明,DHM 在喂养耐受性和胃肠道健康方面可能有一定改善。关于健康婴儿,没有研究涉及生长问题,只有一项研究测量了临床结局,且与母乳喂养结局相关的研究结果相互矛盾。超过一半的综述研究(15/26)并非旨在确定 DHM 使用与相关健康相关结局之间的潜在关系。

目前,除早产儿以外的其他人群中使用 DHM 的证据受到直接健康措施不足和随机试验使用频率低的限制。需要进一步研究来调查临床、生长和母乳喂养结局。

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