Department of Pediatrics, Division of Neonatology & Pediatric Intensive Care, Saxonian Center for Feto/Neonatal Health, University Hospital Carl Gustav Carus Dresden, TU Dresden, 01307 Dresden, Germany.
Int J Environ Res Public Health. 2021 Apr 14;18(8):4140. doi: 10.3390/ijerph18084140.
Early nutrition of newborns significantly influences their long-term health. Mother's own milk (MOM) feeding lowers the incidence of complications in preterm infants and improves long-term health. Unfortunately, prematurity raises barriers for the initiation of MOM feeding and its continuation. Mother and child are separated in most institutions, sucking and swallowing is immature, and respiratory support hinders breastfeeding. As part of a quality-improvement project, we review the published evidence on risk factors of sustained MOM feeding in preterm neonates. Modifiable factors such as timing of skin-to-skin contact, strategies of milk expression, and infant feeding or mode of delivery have been described. Other factors such as gestational age or neonatal complications are unmodifiable, but their recognition allows targeted interventions to improve MOM feeding. All preterm newborns below 34 weeks gestational age discharged over a two-year period from our large German level III neonatal center were reviewed to compare institutional data with the published evidence regarding MOM feeding at discharge from hospital. Based on local data, a risk score for non-MOM feeding can be calculated that helps to identify mother-baby dyads at risk of non-MOM feeding.
新生儿的早期营养对其长期健康有重要影响。母乳喂养（MOM）可降低早产儿并发症的发生率，并改善其长期健康。然而，早产会给 MOM 喂养的启动和持续带来障碍。在大多数机构中，母亲和孩子是分开的，吸吮和吞咽功能不成熟，呼吸支持会阻碍母乳喂养。作为一项质量改进项目的一部分，我们回顾了已发表的关于早产儿持续 MOM 喂养的风险因素的证据。已经描述了一些可改变的因素，如皮肤接触的时间、挤奶策略、婴儿喂养或分娩方式。其他因素如胎龄或新生儿并发症是不可改变的，但认识到这些因素可以针对性地进行干预，以改善 MOM 喂养。对来自我们大型德国三级新生儿中心的在两年期间出院的所有胎龄小于 34 周的早产儿进行了回顾，以比较机构数据与已发表的关于出院时 MOM 喂养的证据。基于本地数据，可以计算出非 MOM 喂养的风险评分，有助于识别有非 MOM 喂养风险的母婴对。
