Lange Matthias, Figura Yannick, Böhne Carolin, Beske Florian, Heep Axel, Bohnhorst Bettina
Department of Pediatrics, University of Oldenburg, Oldenburg, Germany.
Pediatric Pulmology, Allergology and Neonatology, Medizinische Hochschule Hannover, Hannover, Germany.
Z Geburtshilfe Neonatol. 2023 Feb;227(1):51-57. doi: 10.1055/a-1936-0826. Epub 2022 Oct 10.
The advantage of breast milk feeding, and supplementation of probiotics is well known and proven. However, the lack of reliable amounts of colostrum and/or transient breast milk during the first few postnatal days might inhibit timely enteral nutrition.
The aim of this nationwide survey in German Level-1 neonatal intensive care units (NICUs) was to collect data regarding the management of feeding in the first days of life in very low birth weight infants (VLBWIs, birth weight<1500 g). In addition, we analyzed differences in the use of probiotics. An online survey was sent to all 163 Level-1 NICUs in Germany.
110/163 (67.5%) hospitals participated in our study. One-fifth of all participants used exclusively breast milk. The reported incidence of necrotizing enterocolitis (NEC) was lower in NICUs that exclusively used breast milk in VLBWIs (p=0.08). Two-thirds start enteral feeding independent of gestational age during the first 12 hours postnatally with either breast milk or formula. 80% of all participants checked gastric residuals routinely. The use of probiotics differs widely concerning duration and interruption during antibiotic therapy.
The exclusive use of breast milk is associated with a lower incidence of NEC. The result of our survey emphasizes the paramount importance of nutrition with mothers milk. In case of insufficient availability of mothers milk, the use of human donor milk still appears to be superior to formula feeding. The implementation of human donor milk banks should therefore be promoted.
母乳喂养以及补充益生菌的益处已广为人知且得到证实。然而，出生后头几天初乳和/或过渡性母乳量不足可能会妨碍及时的肠内营养。
这项在德国一级新生儿重症监护病房（NICU）开展的全国性调查旨在收集极低出生体重儿（VLBWI，出生体重<1500克）出生后最初几天喂养管理的数据。此外，我们分析了益生菌使用方面的差异。向德国所有163家一级NICU发送了在线调查问卷。
110/163（67.5%）家医院参与了我们的研究。所有参与者中有五分之一仅使用母乳。在VLBWI中仅使用母乳的NICU报告的坏死性小肠结肠炎（NEC）发生率较低（p = 0.08）。三分之二的医院在出生后最初12小时内，无论胎龄如何，均开始用母乳或配方奶进行肠内喂养。所有参与者中有80%常规检查胃残余量。在抗生素治疗期间，益生菌的使用在持续时间和中断情况方面差异很大。
仅使用母乳与较低的NEC发生率相关。我们的调查结果强调了母乳喂养的至关重要性。在母乳供应不足的情况下，使用人乳库捐赠的母乳似乎仍优于配方奶喂养。因此，应推动人乳库的建立。
