School of Nursing, Weifang Medical University, Weifang 261042, China.
School of Nursing, Jining Medical University, Jining 272067, China.
Nutrients. 2022 Apr 21;14(9):1724. doi: 10.3390/nu14091724.
Background: Preterm birth is associated with an increased risk of many complications, which is a main public health problem worldwide with social and economic consequences. Human milk from breast feeding has been proved to be the optimal nutrition strategy for preterm infants when available. However, the lack of human milk from mothers makes formula widely used in clinical practice. In recent years, donated breast milk has gained popularity as an alternative choice which can provide human milk oligosaccharides and other bioactive substances. Objective: We aimed to conduct a systematic review and meta-analysis to evaluate the nutritional effects of donated breast milk on preterm infants compared with formula. Method: In the present study, we searched Medline, Web of Science, Embase, clinicaltrials.gov, the China national knowledge infrastructure, and the Cochrane central register of controlled trials for candidate randomized controlled trials (RCTs). Results: A total of 1390 patients were enrolled in 11 RCTs and meta-analysis results showed that donated breast milk is also more advantageous in reducing the incidence of necrotizing enterocolitis (NEC, RR = 0.67, 95% CI = 0.48 to 0.93, p = 0.02), reducing the duration of parenteral nutrition (MD = −2.39, 95% CI = −3.66 to −1.13, p = 0.0002) and the time of full enteral feeding (MD = −0.33, 95% CI = −3.23 to 2.57, p = 0.0002). In comparison, formula significantly promotes the growth of premature infants, including their weight gain (MD = −3.45, 95% CI = −3.68 to −3.21, p < 0.00001), head growth (MD = −0.07, 95% CI = −0.08 to −0.06, p < 0.00001) and body length (MD = −0.13, 95% CI = −0.15 to −0.11, p < 0.00001), and reduces the time it takes for premature infants to regain birth weight (MD = 6.60, 95% CI = 6.11 to 7.08, p < 0.00001. Conclusion: Compared with formula, donated breast milk could significantly reduce the incidence of NEC, the duration of parenteral nutrition, and the time of full enteral feeding. Adding fortifiers in donated milk could make it as effective as formula in promoting the physical growth of premature infants.
早产儿出生与多种并发症的风险增加有关，这是一个具有社会和经济后果的全球主要公共卫生问题。当可获得人乳时，母乳喂养已被证明是早产儿的最佳营养策略。然而，由于缺乏来自母亲的人乳，配方奶在临床实践中被广泛应用。近年来，捐赠母乳作为一种替代选择越来越受欢迎，因为它可以提供人乳低聚糖和其他生物活性物质。
我们旨在进行系统评价和荟萃分析，以评估与配方奶相比，捐赠母乳对早产儿的营养作用。
在本研究中，我们检索了 Medline、Web of Science、Embase、clinicaltrials.gov、中国知网和 Cochrane 对照试验中心注册库，以寻找候选随机对照试验（RCT）。
共有 1390 名患者纳入 11 项 RCT 进行荟萃分析，结果表明，捐赠母乳在降低坏死性小肠结肠炎（NEC，RR = 0.67，95%CI = 0.48 至 0.93，p = 0.02）、减少肠外营养时间（MD = -2.39，95%CI = -3.66 至 -1.13，p = 0.0002）和完全肠内喂养时间（MD = -0.33，95%CI = -3.23 至 2.57，p = 0.0002）方面也具有更大的优势。相比之下，配方奶显著促进早产儿的生长，包括体重增加（MD = -3.45，95%CI = -3.68 至 -3.21，p < 0.00001）、头围增长（MD = -0.07，95%CI = -0.08 至 -0.06，p < 0.00001）和身长增长（MD = -0.13，95%CI = -0.15 至 -0.11，p < 0.00001），并缩短早产儿恢复出生体重所需的时间（MD = 6.60，95%CI = 6.11 至 7.08，p < 0.00001）。
与配方奶相比，捐赠母乳可显著降低 NEC 的发生率、肠外营养的时间和完全肠内喂养的时间。在捐赠奶中添加强化剂可以使其在促进早产儿的身体生长方面与配方奶一样有效。
