Neonatal Unit and Human Milk Bank, Da Nang Hospital for Women and Children, Da Nang 50506, Vietnam.
Department of Pediatrics, School of Medicine and Pharmacy, The University of Da Nang, Da Nang 50206, Vietnam.
Nutrients. 2021 Mar 31;13(4):1151. doi: 10.3390/nu13041151.
Pasteurized donor milk (PDM) is typically prescribed to preterm or low birthweight newborns when their mother's own milk is unavailable. In surplus, PDM is prescribed to meet the nutritional needs of healthy newborns in the first few days of life. However, its overuse can undermine efforts to promote and support breastfeeding, waste resources, and reduce the availability of PDM for at-risk newborns. We conducted this study to examine factors associated with the prescription and prolonged use (>48 h) of privately purchased PDM to healthy newborns.
Prospective observational study of 2440 mothers of healthy, term, and normal birthweight newborns born at Da Nang Hospital for Women and Children between April and August 2019. In addition to the descriptive analysis, we performed multiple logistic regressions to examine factors associated with the prescription of PDM ( = 2440) and prolonged PDM use among those who used PDM ( = 566).
Twenty-three percent (566/2440) of healthy, term, and birthweight ≥2500 g newborns received PDM and were included in the study. The prevalence of PDM use was higher for cesarean births (OR: 2.05; 95% CI: 1.66, 2.55) and among male newborns (OR: 1.33; 95% CI: 1.09, 1.62), but lower for farmers or workers (vs. other jobs; OR: 0.71; 95% CI: 0.54, 0.93), family income <10 million VND (vs. ≥10 million VND; OR: 0.67; 95% CI: 0.55, 0.82), and duration of skin-to-skin ≥90 min (vs. <90 min; OR: 0.54; 95% CI: 0.39, 0.76). Prolonged PDM use (12.4% of 566 newborns who used PDM) was associated with the mother having a higher socioeconomic status job (professional, small trader or homemaker; OR: 4.00; 95% CI: 1.39, 12.5), being a first-time mother (OR: 3.39; 95% CI: 1.92, 6.01) or having a cesarean birth (OR: 2.09; 95% CI: 1.02, 4.28).
The prescription and prolonged use of privately purchased PDM was associated with non-medical factors unrelated to the ability to breastfeed effectively. The findings suggest the need for improved breastfeeding communication, counseling and support skills for health staff, development, and application of strict criteria on PDM use for healthy newborns and better routine monitoring of PDM use over time.
当母亲的母乳无法满足早产儿或低出生体重儿的需求时，通常会开巴氏消毒的捐赠奶（PDM）。在有剩余的情况下，PDM 也会被开给刚出生几天的健康新生儿，以满足他们的营养需求。然而，PDM 的过度使用会破坏促进和支持母乳喂养的努力，浪费资源，并减少高危新生儿获得 PDM 的机会。我们进行了这项研究，以调查与私人购买 PDM 用于健康新生儿的处方和长期使用（>48 小时）相关的因素。
对 2019 年 4 月至 8 月在岘港妇幼医院分娩的 2440 名健康、足月和正常出生体重的母亲进行前瞻性观察性研究。除了描述性分析，我们还进行了多项逻辑回归分析，以调查与 PDM 处方（=2440）和使用 PDM 的婴儿（=566）的 PDM 长期使用相关的因素。
23%（566/2440）的健康、足月和出生体重≥2500 克的新生儿接受了 PDM 治疗，并纳入研究。剖宫产分娩（OR：2.05；95%CI：1.66，2.55）和男婴（OR：1.33；95%CI：1.09，1.62）的 PDM 使用比例较高，而农民或工人（与其他工作相比；OR：0.71；95%CI：0.54，0.93）、家庭收入<1000 万越南盾（与收入≥1000 万越南盾相比；OR：0.67；95%CI：0.55，0.82）和皮肤接触时间≥90 分钟（与皮肤接触时间<90 分钟相比；OR：0.54；95%CI：0.39，0.76）的 PDM 使用比例较低。PDM 的长期使用（566 名使用 PDM 的新生儿中有 12.4%）与母亲从事较高社会经济地位的工作（专业人士、小商贩或家庭主妇；OR：4.00；95%CI：1.39，12.5）、初次生育（OR：3.39；95%CI：1.92，6.01）或剖宫产分娩（OR：2.09；95%CI：1.02，4.28）有关。
私人购买 PDM 的处方和长期使用与与有效母乳喂养能力无关的非医学因素有关。这些发现表明，需要提高卫生工作人员的母乳喂养沟通、咨询和支持技能，制定和应用严格的 PDM 使用标准，并对 PDM 的使用进行长期常规监测。
