Department of Behavioral Health and Nutrition, University of Delaware, 318 STAR Tower, 100 Discovery Blvd., Newark, DE, 19713, USA.
Lactation Department, The Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA.
Pediatr Cardiol. 2023 Apr;44(4):882-891. doi: 10.1007/s00246-022-03023-7. Epub 2022 Oct 25.
The purpose of this study was to determine the relationship between patterning of human milk feeding and growth of infants with congenital heart defects in the first year of life. Inclusion criteria for this prospective cohort study included infants 0-21 days, who had undergone or had planned neonatal corrective or palliative surgery prior to hospital discharge, and whose mothers planned to feed human milk. Data on anthropometric measures (weight, length, head circumference) and infant milk type (human milk, formula, other) were collected at nine time points (0.5, 1, 2, 3, 4, 6, 8, 10, 12 months). Anthropometric data were converted to weight-for-age, length-for-age, head circumference-for-age, and weight-for-length Z-scores using World Health Organization growth reference data. Cluster analysis identified three milk type feeding patterns in the first year: Infants fed human milk only with no formula supplementation, infants fed human milk who then transitioned to a mix of human milk and formula, and infants who fed human milk and transitioned to formula only. General linear models assessed the effect of milk type feeding patterns on growth parameters over time. No effect of milk type pattern × time was found on longitudinal changes in weight-for-age (p for interaction = 0.228), length-for-age (p for interaction = 0.173), weight-for-length (p for interaction = 0.507), or head circumference-for-age (p for interaction = 0.311) Z-scores. In this cohort study, human milk alone or combined with infant formula supported age-appropriate growth in infants with congenital heart defects in the first year.
本研究旨在确定人乳喂养模式与先天性心脏病婴儿在生命第一年生长之间的关系。这项前瞻性队列研究的纳入标准包括 0-21 天大的婴儿，这些婴儿在出院前已经接受或计划接受新生儿矫正或姑息性手术，并且其母亲计划母乳喂养。在九个时间点（0.5、1、2、3、4、6、8、10、12 个月）收集了关于人体测量学指标（体重、长度、头围）和婴儿乳类（人乳、配方奶、其他）的数据。将人体测量数据转换为体重-年龄、长度-年龄、头围-年龄和体重-长度 Z 分数，使用世界卫生组织生长参考数据。聚类分析确定了婴儿第一年的三种乳类喂养模式：仅用人乳喂养而不补充配方奶的婴儿、先用人乳喂养然后过渡到人乳和配方奶混合喂养的婴儿、以及先用人乳喂养然后过渡到仅用人乳喂养的婴儿。使用一般线性模型评估了不同喂养模式对生长参数随时间变化的影响。在体重-年龄（交互作用 P 值=0.228）、长度-年龄（交互作用 P 值=0.173）、体重-长度（交互作用 P 值=0.507）和头围-年龄（交互作用 P 值=0.311）Z 分数的纵向变化方面，未发现乳类喂养模式与时间之间存在相互作用。在这项队列研究中，先天性心脏病婴儿在第一年单独用人乳或与婴儿配方奶结合喂养均可支持其与年龄相适应的生长。
