Bramer Solange, Boyle Robert, Weaver Gillian, Shenker Natalie
Imperial College London Medical School, St Mary's Hospital, London, UK.
Department of Paediatrics, Imperial College London, St Mary's Hospital, London, UK.
Matern Child Nutr. 2021 Apr;17(2):e13128. doi: 10.1111/mcn.13128. Epub 2021 Jan 6.
When mother's own milk (MOM) is unavailable or insufficient, donor human milk (DHM) is recommended as the next best alternative for low birthweight infants. DHM use for healthy, term infants is increasing, but evidence for growth and tolerability is limited. This retrospective study evaluated growth in term infants in the community who received DHM from a UK milk bank. Mothers of infants receiving DHM between 2017 and 2019 were contacted (n = 49), and 31 (63.2%) agreed to participate. Fourteen infants received DHM as a supplement to other feeds (MOM and/or infant formula) and 17 were exclusively fed DHM where breastfeeding was impossible (range: 3-6 weeks). Growth was assessed by deriving z-scores using the WHO standard for infant growth and compared with 200 exclusively breastfed infants. Multivariate regression analysis revealed no feeding method-specific association between z-score and age, nor between weight and age, suggesting that z-scores and growth velocity were not affected by feeding exclusive MOM, supplemental DHM or exclusive DHM. DHM was well-tolerated with no adverse events that led to early cessation. After receiving supplemental DHM group, 63% of infants whose mothers had no physical barrier to breastfeeding (5/8 infants) were exclusively breastfed. This novel study reports adequate growth outcomes of healthy nonhospitalized infants receiving DHM, either as the sole milk source or supplement. Prospective studies are needed to confirm whether DHM is a suitable feeding alternative for term infants in the community, optimal durations, as well as the impact of DHM availability on breastfeeding rates and maternal mental health.
当无法获得或母乳不足时，建议为低体重婴儿提供捐赠母乳（DHM）作为次优选择。DHM在健康足月儿中的使用正在增加，但关于其生长和耐受性的证据有限。这项回顾性研究评估了在社区中接受英国母乳库提供的DHM的足月儿的生长情况。研究人员联系了2017年至2019年间接受DHM的婴儿的母亲（n = 49），其中31位（63.2%）同意参与研究。14名婴儿接受DHM作为其他喂养方式（母乳和/或婴儿配方奶粉）的补充，17名婴儿在无法进行母乳喂养的情况下完全接受DHM喂养（范围：3 - 6周）。使用世界卫生组织婴儿生长标准得出z值来评估生长情况，并与200名纯母乳喂养的婴儿进行比较。多变量回归分析显示，z值与年龄之间以及体重与年龄之间不存在特定喂养方式的关联，这表明z值和生长速度不受纯母乳喂养、补充DHM或纯DHM喂养的影响。DHM耐受性良好且没有导致提前停止喂养的不良事件。在接受补充DHM组后，63%的母亲在母乳喂养方面没有身体障碍的婴儿（5/8名婴儿）实现了纯母乳喂养。这项新研究报告了接受DHM作为唯一奶源或补充喂养的健康非住院婴儿有足够的生长结果。需要进行前瞻性研究以确认DHM是否是社区中足月儿合适的喂养替代方式、最佳持续时间，以及DHM的可获得性对母乳喂养率和母亲心理健康的影响。
