Department of Pediatrics, Maternity Hospital Affiliated to Nanjing Medical University/ Nanjing Maternal and Child Health Hospital, Nanjing, Jiangsu, China.
Department of Pediatrics, University of Toronto Faculty of Medicine, Toronto, ON, Canada.
BMC Pediatr. 2023 Feb 11;23(1):75. doi: 10.1186/s12887-023-03862-0.
The breastfeeding rate in China is lower than that in many other countries and the extent of adoption of the "Feeding Recommendations for Preterm Infants and Low Birth Weight Infants" guideline in NICUs remains unclear.
A web-based survey about the current status of human milk feeding and enteral feeding practices at NICUs was sent to all China Neonatal Network's cooperation units on September 7, 2021, and the respondents were given a month to send their responses.
All sixty NICUs responded to the survey, the reply rate was 100%. All units encouraged breastfeeding and provided regular breastfeeding education. Thirty-six units (60.0%) had a dedicated breastfeeding/pumping room, 55 (91.7%) provided kangaroo care, 20 (33.3%) had family rooms, and 33 (55.0%) routinely provided family integrated care. Twenty hospitals (33.3%) had their own human milk banks, and only 13 (21.7%) used donor human milk. Eight units (13.3%) did not have written standard nutrition management guidelines for infants with body weight < 1500 g. Most units initiated minimal enteral nutrition with mother's milk for infants with birth weight ˂1500 g within 24 h after birth. Fifty NICUs (83.3%) increased the volume of enteral feeding at 10-20 ml/kg daily. Thirty-one NICUs (51.7%) assessed gastric residual content before every feeding session. Forty-one NICUs (68.3%) did not change the course of enteral nutrition management during drug treatment for patent ductus arteriosus, and 29 NICUs (48.3%) instated NPO for 1 or 2 feeds during blood transfusion.
There were significant differences in human milk feeding and enteral feeding strategies between the NICUs in CHNN, but also similarities. The data obtained would be useful in the establishment of national enteral feeding guidelines for preterm infants and quality improvement of cooperation at the national level.
中国的母乳喂养率低于许多其他国家，且新生儿重症监护病房（NICU）对《早产儿和低出生体重儿喂养建议》指南的采用程度尚不清楚。
2021 年 9 月 7 日，我们向中国新生儿网络（China Neonatal Network，CHNN）的所有合作单位发送了一份关于 NICU 中母乳喂养和肠内喂养实践现状的网络调查，回复期限为一个月。
所有 60 家 NICU 均对调查做出了回应，回复率为 100%。所有单位均鼓励母乳喂养，并定期提供母乳喂养教育。36 家（60.0%）单位设有专门的母乳喂养/挤奶室，55 家（91.7%）提供袋鼠式护理，20 家（33.3%）设有家庭病房，33 家（55.0%）常规提供家庭综合护理。20 家医院（33.3%）设有自有母乳库，仅 13 家（21.7%）使用捐赠母乳。8 家（13.3%）单位没有针对体重＜1500 g 的婴儿的书面标准营养管理指南。大多数单位在出生后 24 h 内为出生体重＜1500 g 的婴儿启动了微量肠内营养，使用母亲的奶。50 家 NICU（83.3%）每天增加 10-20 ml/kg 的肠内喂养量。31 家 NICU（51.7%）在每次喂养前评估胃残留量。41 家 NICU（68.3%）在使用前列腺素 E1 治疗动脉导管未闭期间不改变肠内营养管理方案，29 家 NICU（48.3%）在输血期间禁食 1 或 2 次。
CHNN 中的 NICU 在母乳喂养和肠内喂养策略方面存在显著差异，但也存在相似之处。获得的数据将有助于制定国家早产儿肠内喂养指南和提高全国合作的质量。
