Neonatal Nutrition and Gastroenterology Program, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Pediatrics, Jim Pattison Children Hospital, Saskatoon, Saskatchewan, Canada.
Neonatal Nutrition and Gastroenterology Program, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
J Pediatr. 2021 Sep;236:21-27.e4. doi: 10.1016/j.jpeds.2021.04.037. Epub 2021 Apr 24.
To examine rates and determinants of mother's own milk (MOM) feeding at hospital discharge in a cohort of infants born very preterm within the Canadian Neonatal Network (CNN).
This was a population-based cohort study of infants born at <33 weeks of gestation and admitted to neonatal intensive care units (NICUs) participating in the CNN between January 1, 2015, and December 31, 2018. We examined the rates and determinants of MOM use at discharge home among the participating NICUs. We used multivariable logistic regression analysis to identify independent determinants of MOM feeding.
Among the 6404 infants born very preterm and discharged home during the study period, 4457 (70%) received MOM or MOM supplemented with formula. Rates of MOM feeding at discharge varied from 49% to 87% across NICUs. Determinants associated with MOM feeding at discharge were gestational age 29-32 weeks compared with <26 weeks (aOR 1.56, 95% CI 1.25-1.93), primipara mothers (aOR 2.12, 95% CI 1.86-2.42), maternal diabetes (aOR 0.79, 95% CI 0.66-0.93), and maternal smoking (aOR 0.27, 95% CI 0.19-0.38). Receipt of MOM by day 3 of age was the major predictor of breast milk feeding at discharge (aOR 3.61, 95% CI 3.17-4.12).
Approximately two-thirds of infants born very preterm received MOM at hospital discharge, and rates varied across NICUs. Supporting mothers to provide breast milk in the first 3 days after birth may be associated with improved MOM feeding rates at discharge.
在加拿大新生儿网络（CNN）中，研究出生极低体重儿队列中母亲自身母乳（MOM）喂养在出院时的比例及其决定因素。
这是一项基于人群的队列研究，纳入了 2015 年 1 月 1 日至 2018 年 12 月 31 日期间在 CNN 中参与的胎龄<33 周并入住新生儿重症监护病房（NICU）的婴儿。我们研究了参与 NICU 中出院时 MOM 使用的比例及其决定因素。我们使用多变量逻辑回归分析确定 MOM 喂养的独立决定因素。
在研究期间出生极低体重并出院回家的 6404 名婴儿中，4457 名（70%）接受了 MOM 或 MOM 加配方奶。NICU 出院时 MOM 喂养率从 49%到 87%不等。与<26 周相比，与胎龄 29-32 周（aOR 1.56，95%CI 1.25-1.93）、初产妇（aOR 2.12，95%CI 1.86-2.42）、母亲糖尿病（aOR 0.79，95%CI 0.66-0.93）和母亲吸烟（aOR 0.27，95%CI 0.19-0.38）相关的因素与 MOM 喂养相关。出生后第 3 天开始接受 MOM 是出院时母乳喂养的主要预测因素（aOR 3.61，95%CI 3.17-4.12）。
大约三分之二的极低出生体重儿在出院时接受了 MOM，并且各 NICU 之间的比例存在差异。在出生后的前 3 天内支持母亲提供母乳可能与提高出院时 MOM 喂养率有关。
