探索新生儿营养与喂养的当前实践、挑战及创新，包括人乳、强化剂和配方奶的使用：一项临床研究。
Exploring Current Practices, Challenges, and Innovations in the Nutrition and Feeding of Neonates, Including the Use of Human Milk, Fortifiers, and Formula: A Clinical Study.
作者信息
Chaudhuri Partha K, Madhur Abha, Anshu Kumar, Kumari Shiromani, Singh Jyotsna, Sarangam Barapatla, Sarkar Pratik
机构信息
Department of Paediatrics, Rajendra Institute of Medical Science, Ranchi, Jharkhand, India.
出版信息
J Pharm Bioallied Sci. 2024 Jul;16(Suppl 3):S2815-S2817. doi: 10.4103/jpbs.jpbs_431_24. Epub 2024 Jul 31.
BACKGROUND
Neonatal nutrition plays a crucial role in the growth and development of infants, particularly in the neonatal intensive care unit (NICU) where specialized care is essential. This study aims to explore current practices, challenges, and innovations in the nutrition and feeding of neonates, focusing on the utilization of human milk, fortifiers, and formula.
MATERIALS AND METHODS
A retrospective clinical study was conducted at a tertiary care NICU over a period of two years. Data were collected from medical records of neonates admitted to the unit. Information regarding feeding practices, types of milk (human milk, fortified human milk, or formula), fortification protocols, and associated clinical outcomes were analyzed.
RESULTS
A total of 150 neonates were included in the study. The majority (85%) received some form of human milk during their NICU stay, with 60% exclusively receiving human milk. Among those receiving human milk, 40% required fortification with a human milk fortifier due to inadequate growth parameters. Formula supplementation was necessary in 25% of cases due to maternal lactation insufficiency or medical contraindications to human milk. The mean duration of parenteral nutrition was 10 days, with a median time to full enteral feeds of 14 days. Infants receiving exclusively human milk demonstrated a lower incidence of necrotizing enterocolitis (NEC) compared to those receiving formula (5% vs. 12%, < 0.05).
CONCLUSION
Human milk remains the preferred source of nutrition for neonates in the NICU setting, associated with lower rates of NEC and improved clinical outcomes. However, fortification with human milk fortifiers or supplementation with formula is often necessary to meet the nutritional requirements of preterm infants. Further research is needed to optimize fortification protocols and improve long-term outcomes in this vulnerable population.
背景
新生儿营养在婴儿的生长发育中起着至关重要的作用，尤其是在需要专业护理的新生儿重症监护病房（NICU）。本研究旨在探讨新生儿营养与喂养方面的当前实践、挑战和创新，重点关注母乳、强化剂和配方奶的使用。
材料与方法
在一家三级护理NICU进行了为期两年的回顾性临床研究。从该病房收治的新生儿病历中收集数据。分析了有关喂养方式、奶的类型（母乳、强化母乳或配方奶）、强化方案以及相关临床结局的信息。
结果
共有150名新生儿纳入研究。大多数（85%）在NICU住院期间接受了某种形式的母乳，其中60%纯母乳喂养。在接受母乳的婴儿中，40%因生长指标不达标需要使用母乳强化剂进行强化。由于母亲泌乳不足或母乳的医学禁忌，25%的病例需要补充配方奶。肠外营养的平均持续时间为10天，完全肠内喂养的中位时间为14天。与接受配方奶的婴儿相比，纯母乳喂养的婴儿坏死性小肠结肠炎（NEC）的发生率较低（5%对12%，<0.05）。
结论
在NICU环境中，母乳仍然是新生儿首选的营养来源，与较低的NEC发生率和改善的临床结局相关。然而，通常需要使用母乳强化剂进行强化或补充配方奶，以满足早产儿的营养需求。需要进一步研究以优化强化方案并改善这一脆弱人群的长期结局。
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