Neonatal Intensive Care Unit, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.
HMB, Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.
Nutrients. 2023 Jul 26;15(15):3314. doi: 10.3390/nu15153314.
Mothers' own milk (MOM) for premature babies is considered a life-saving drug for its proven protective action against the complications of prematurity and for effects on outcome in the short and long term, especially neurological ones. We studied the use of MOM for infants weighing <1500 g for a period of 5 years, evaluating the trend over time and the impact of some variables on human milk feeding performance. Statistical comparisons concerned the rate of feeding with breast milk during a stay in an NICU and at discharge with respect to two types of variables: (1) maternal and neonatal characteristics (gestational age, birth weight, type of pregnancy (whether single or twin), maternal age) and (2) feeding characteristics (time of the start of minimal enteral feeding and availability of MOM, days until the achievement of full enteral feeding). Group comparisons were performed using ANOVA or -test for continuous variables and Pearson chi-squared test or Fisher exact test for categorical variables. We observed an increase, between 2017 and 2021, in MOM use ( = 0.003). The availability of the own mothers' milk occurred, on average, on the fourth day of life and improved over the years. The start of minimal enteral feeding (MEF) with human milk averaged 1.78 days, and 54.3% of VLBWs received MEF with donor milk on the first day of life. The average percentage of feeding with the mothers' milk at discharge was 47.6%, with 36.1% of exclusive MOM and an increase from 45.8% in 2017 (33.3% exclusive) to 58.82% (41.18% exclusive) in 2021. The mean average daily growth of the weight improved ( < 0.001) during this period, and there was no statistical difference between infants fed with maternal milk and those fed with bank milk. Older maternal age, early-start feeding with maternal milk and low gestational age had a statistically significant impact on feeding with MOM at discharge.
对于早产儿来说,母亲自己的奶(MOM)被认为是一种救命药物,因为它已被证明具有预防早产并发症和对短期和长期结果的作用,特别是对神经方面的作用。我们研究了在 5 年内对体重<1500 克的婴儿使用 MOM 的情况,评估了随着时间的推移的趋势以及一些变量对人乳喂养表现的影响。统计比较涉及在 NICU 住院期间和出院时母乳喂养的比率,以及以下两种类型的变量:(1)产妇和新生儿特征(胎龄、出生体重、妊娠类型(单胎或双胎)、产妇年龄)和(2)喂养特征(开始微量肠内喂养的时间和 MOM 的可用性、达到完全肠内喂养的天数)。使用方差分析或 t 检验对连续变量进行组间比较,使用 Pearson 卡方检验或 Fisher 确切检验对分类变量进行组间比较。我们观察到,在 2017 年至 2021 年期间,MOM 的使用有所增加(=0.003)。母亲自己的奶平均在出生后的第四天供应,并在这些年间有所改善。开始微量肠内喂养(MEF)的时间为 1.78 天,54.3%的极低出生体重儿在生命的第一天接受了捐赠奶的 MEF。出院时母乳喂养的平均百分比为 47.6%,其中 36.1%为纯母乳喂养,从 2017 年的 45.8%(33.3%为纯母乳喂养)增加到 2021 年的 58.82%(41.18%为纯母乳喂养)。在此期间,体重的平均日增长得到改善(<0.001),且接受母乳和银行奶喂养的婴儿之间没有统计学差异。母亲年龄较大、早期开始母乳喂养和较低的胎龄对出院时母乳喂养 MOM 有统计学上的显著影响。