McCormick Kenny, King Caroline, Clarke Sara, Jarvis Chris, Johnson Mark, Parretti Helen M, Greene Nora, Males Joanna
Consultant Neonatologist, John Radcliffe Hospital, Oxford.
Neonatal Dietitian, Imperial NHS Trust, London.
Br J Hosp Med (Lond). 2021 Mar 2;82(3):42-48. doi: 10.12968/hmed.2021.0101. Epub 2021 Mar 9.
Infants born prematurely are often discharged from hospital before 37 weeks post-menstrual age. While breastfeeding will meet all the nutritional requirements of full-term infants, these preterm infants may need enhanced levels of protein, minerals and possibly energy to ensure optimum growth, bone mineralisation and neurological development. To meet these additional nutrient needs in the neonatal unit, it is currently recommended that multinutrient breast milk fortifier is added to maternal breast milk. There may also be benefits in continuing to provide fortified milk after discharge, potentially including improved growth and preserving breastfeeding, and this is increasingly becoming a recognised practice in some neonatal units. This article presents the discussion and consensus of a multidisciplinary panel of neonatologists, neonatal dietitians, a GP and a neonatal outreach sister. The aim is to develop guidance on providing safe and effective nutritional supplementation for preterm infants after discharge in order to maintain optimal growth. This guidance is aimed at community healthcare staff and is based on the limited evidence available, using shared best practice and expertise.
早产婴儿通常在孕龄37周前出院。虽然母乳喂养能满足足月儿的所有营养需求，但这些早产儿可能需要更高水平的蛋白质、矿物质以及可能的能量，以确保最佳生长、骨骼矿化和神经发育。为满足新生儿病房中这些额外的营养需求，目前建议在母乳中添加多营养素母乳强化剂。出院后继续提供强化奶可能也有好处，潜在益处包括促进生长和维持母乳喂养，这在一些新生儿病房正日益成为一种公认的做法。本文介绍了由新生儿科医生、新生儿营养师、一名全科医生和一名新生儿外展护士组成的多学科小组的讨论和共识。目的是制定关于出院后为早产儿提供安全有效营养补充以维持最佳生长的指导意见。本指导意见针对社区医护人员，基于有限的现有证据，采用共同的最佳实践和专业知识。
