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袋鼠式护理对早产儿长期母乳喂养率、生长和神经发育的积极影响。

Positive Effects of Kangaroo Mother Care on Long-Term Breastfeeding Rates, Growth, and Neurodevelopment in Preterm Infants.

机构信息

Department of Neonatal Intensive Care Unit, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.

School of Nursing, University of Connecticut, Storrs, Connecticut, USA.

出版信息

Breastfeed Med. 2021 Apr;16(4):282-291. doi: 10.1089/bfm.2020.0358. Epub 2021 Feb 2.

Abstract

Kangaroo mother care (KMC) benefits preterm infants' health through increasing breastfeeding, but the longitudinal effects of KMC remain unknown. This study investigates the impact of KMC on breastfeeding and health outcomes in Chinese preterm infants. A longitudinal randomized controlled study was conducted with 79 preterm infant-mother dyads. The KMC group ( = 36) was provided 2.5 hours/day KMC during the neonatal intensive care unit (NICU) hospitalization, while the control group ( = 43) received standard care. Infant's feeding regimens and physical growth were documented daily at NICU. Physical growth and Neonatal Behavioral Neurological Assessment were measured at 40 weeks, 3 months, and 6 months of corrected age (CA). Breastfeeding outcomes were documented at 6 months of CA. Compared with the control group, KMC infants received higher mothers' milk proportion during hospitalization ( = 0.16, confidence interval [CI] = [0.11-0.21]) and less feeding intolerance at discharge (odds ratio [OR] = 0.11, CI = [0.02-0.43]); and higher exclusive breastfeeding proportion (OR = 14.6, CI = [3.5-60.9]) at 6 months CA. KMC infants also had significant increased body weight and body length at hospital discharge; and more increases of body weight, body length, and head circumference in follow-ups. The neurobehavioral score was also higher in the KMC group compared to the control group over time. Longitudinal KMC effects are significant in promoting preterm infants' breastfeeding outcomes, growth, and neurodevelopment. Early initiation of KMC practice is highly recommended to the parent-infant population in Chinese NICUs to promote breastfeeding and developmental outcomes.

摘要

袋鼠式护理(KMC)通过增加母乳喂养有益于早产儿的健康,但 KMC 的长期影响尚不清楚。本研究调查了 KMC 对中国早产儿母乳喂养和健康结果的影响。

进行了一项纵向随机对照研究,共纳入 79 对早产儿-母亲对。KMC 组(n=36)在新生儿重症监护病房(NICU)住院期间每天接受 2.5 小时的 KMC,对照组(n=43)接受标准护理。每天在 NICU 记录婴儿的喂养方案和体格生长情况。在 40 周、3 个月和 6 个月校正年龄(CA)时测量体格生长和新生儿行为神经评估。在 6 个月 CA 时记录母乳喂养结果。

与对照组相比,KMC 婴儿在住院期间接受了更高比例的母乳(n=0.16,置信区间 [CI] = [0.11-0.21]),出院时更少发生喂养不耐受(比值比 [OR] = 0.11,CI = [0.02-0.43]);6 个月 CA 时纯母乳喂养比例更高(OR = 14.6,CI = [3.5-60.9])。KMC 婴儿在出院时体重和身长也显著增加;随访中体重、身长和头围增加更多。与对照组相比,KMC 组的神经行为评分随着时间的推移也更高。

纵向 KMC 效应在促进早产儿母乳喂养结果、生长和神经发育方面具有显著意义。强烈建议中国 NICU 的母婴群体尽早开始 KMC 实践,以促进母乳喂养和发育结果。

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