Department of Clinical Nutrition, Children's Wisconsin, Milwaukee, Wisconsin, USA.
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Nutr Clin Pract. 2023 Feb;38(1):199-203. doi: 10.1002/ncp.10887. Epub 2022 Jul 2.
To learn how skimmed human milk (SHM) can be used in infants with chylothorax to support adequate weight gain and nutrition while receiving human milk.
Traditional nutrition management for chylothorax is to limit long-chain triglycerides (LCTs) and provide a diet high in medium-chain triglycerides (MCTs). Transition from human milk to formula has been required to provide the ratio of MCT to LCT required to stop the accumulation of chyle. Although SHM may provide the right fat content for a baby with chylothorax, previous studies have shown slow growth in infants receiving SHM.
To demonstrate that infants receiving SHM fortified with high-MCT infant formula will have age appropriate growth without re-accumulation of chyle.
DESIGN/METHODS: Between 2017 and 2019, term infants with the diagnosis of chylothorax who were previously receiving human milk and transitioned to fortified SHM were monitored for growth and reaccumulation of chyle.
The six infants who were prescribed fortified SHM with high-MCT infant formula using standardized recipes did not show reaccumulation of chyle and showed positive weight gain in five of the six study patients. The infants gained a mean weight of 30.5 g/day (±19.5), and their weight z scores improved by a mean of +0.29 (±0.33).
Fortified SHM is a safe treatment option that can provide adequate nutrition for the infant with chylothorax to gain weight appropriately for age.
了解如何在患有乳糜胸的婴儿中使用脱脂人乳 (SHM)，以在接受人乳的同时支持足够的体重增加和营养。
传统的乳糜胸营养管理是限制长链甘油三酯 (LCT)，并提供富含中链甘油三酯 (MCT) 的饮食。为了提供停止乳糜积聚所需的 MCT 与 LCT 比例，需要从人乳过渡到配方奶。尽管 SHM 可能为人乳喂养的患有乳糜胸的婴儿提供正确的脂肪含量，但之前的研究表明，接受 SHM 的婴儿生长缓慢。
证明接受富含高 MCT 婴儿配方奶粉的 SHM 强化的婴儿在没有乳糜再积聚的情况下会有适当的生长。
设计/方法：在 2017 年至 2019 年期间，监测了先前接受人乳并过渡到强化 SHM 的患有乳糜胸的足月婴儿的生长和乳糜再积聚情况。
使用标准化配方为六名婴儿开了富含高 MCT 婴儿配方奶粉的强化 SHM，这六名婴儿均未出现乳糜再积聚，并且六名研究患者中有五名体重增加呈阳性。婴儿的平均体重增加为 30.5g/天（±19.5），体重 z 评分平均提高 0.29（±0.33）。
强化 SHM 是一种安全的治疗选择，可以为人乳喂养的患有乳糜胸的婴儿提供充足的营养，使其体重按年龄适当增加。
