Department of Public Health, Policy and Social Sciences, College of Human and Health Sciences, Swansea University, Swansea, UK.
Matern Child Nutr. 2021 Oct;17(4):e13182. doi: 10.1111/mcn.13182. Epub 2021 May 6.
Exclusive breastfeeding for the first 6 months and then alongside solid food for the first 2 years and beyond is the gold standard in young child nutrition. There is an abundance of literature relating to the preventative nature of breastmilk and breastfeeding against many infectious diseases and chronic conditions. However, despite medically complex infants and children being a group that could benefit most from continued breastfeeding, breastfeeding duration and exclusivity are lower among more complex paediatric populations. The reasons for this are not well known, and there is a paucity of data relating to supporting infants who have acute or chronic illness, disability or congenital anomaly to breastfeed. This systematic review aimed to understand the challenges of breast/chestfeeding the medically complex child and to establish the gaps in healthcare provision that act as barriers to optimal infant and young child feeding. The search was limited to studies published in English, focused on breastfed sick infants in hospital, with no date limits as there is no previous systematic review. Of 786 papers retrieved, 11 studies were included for review, and seven themes identified. Themes included practical and psychological challenges of continuing to breastfeed in a hospital setting, complications of the condition making breastfeeding difficult, lack of specialist breastfeeding support from hospital staff and a lack of availability of specialist equipment to support complex breastfeeding. The findings affirm the lack of consistent high-quality care for lactation support in paediatric settings and reinforce the need for further focused research in this area.
纯母乳喂养应持续 6 个月，之后在添加固体食物的同时继续母乳喂养至 2 岁及以上，这是婴幼儿营养的黄金标准。有大量文献表明，母乳和母乳喂养对许多传染病和慢性病具有预防作用。然而，尽管医学上复杂的婴儿和儿童是最能从持续母乳喂养中受益的群体，但在更复杂的儿科人群中，母乳喂养的持续时间和排他性较低。其原因尚不清楚，也缺乏与支持患有急性或慢性疾病、残疾或先天异常的婴儿进行母乳喂养相关的数据。本系统评价旨在了解母乳喂养医学复杂儿童的挑战，并确定作为最佳婴幼儿喂养障碍的医疗保健服务提供差距。搜索仅限于以英语发表的研究，重点关注住院的母乳喂养患病婴儿，没有时间限制，因为以前没有进行过系统评价。在检索到的 786 篇论文中，有 11 项研究被纳入综述，确定了 7 个主题。主题包括在医院环境中继续母乳喂养的实际和心理挑战、病情使母乳喂养变得困难的并发症、医院工作人员缺乏专业母乳喂养支持以及缺乏支持复杂母乳喂养的专用设备。研究结果证实了儿科环境中缺乏一致的高质量母乳喂养支持，并强调需要在这一领域进行进一步的重点研究。
