新生儿重症监护病房中胎龄小于33周早产儿的牛奶摄入量类型和数量

Type and Volume of Milk Intake in Premature Infants <33 Weeks Gestational Age in the Neonatal Intensive Care Unit.

作者信息

Narasimhan Sudha Rani, Vallejo Maricela, Nudelman Matthew, Jegatheesan Priya

机构信息

Division of Neonatology, Department of Pediatrics, Santa Clara Valley Medical Center, San Jose, CA 95128, USA.

Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA.

出版信息

Children (Basel). 2025 Mar 29;12(4):431. doi: 10.3390/children12040431.

Abstract

BACKGROUND

Understanding the patterns of milk intake in the neonatal intensive care unit (NICU) will allow opportunities to intervene to improve mother's milk supply.

OBJECTIVE

To quantify the type and volume of milk intake in premature infants throughout the NICU stay.

METHODS

This retrospective observational cohort study included infants born and admitted to the NICU at <33 weeks gestation from January 2014 to December 2017 who did not have contraindications for receiving mother's own milk (MOM). Daily volume of MOM, pasteurized donor milk (PDM), and formula throughout the NICU stay were collected. Infants were categorized as exclusive human milk diet (EHM) if they consumed MOM and PDM or mixed diet if they consumed formula and MOM and/or PDM. Demographics, feeding outcomes, growth outcomes, and neonatal morbidities were collected.

RESULTS

Of 195 study infants, 133 (32%) received EHM. Cumulative volume and percent of MOM intake were greater in the EHM group compared to the mixed diet group. Age of first colostrum administration to infant was earlier in the EHM group than the mixed diet group (3.1 vs. 4.9, = 0.013). By the second week of life, the EHM group received 100% of their feeds as MOM but the maximum MOM received in the mixed diet group was 63%. There was no difference in other feeding or neonatal outcomes between the groups.

CONCLUSION

The EHM group received colostrum earlier than those who received a mixed diet with formula and reached full MOM by the second week of life. This represents the opportunity to address challenges of milk supply of mothers with premature infants in the NICU in the first two weeks after birth.

摘要

背景

了解新生儿重症监护病房(NICU)的母乳摄入量模式将为采取干预措施以增加母乳供应提供机会。

目的

量化早产儿在整个NICU住院期间的母乳摄入类型和量。

方法

这项回顾性观察性队列研究纳入了2014年1月至2017年12月在妊娠<33周时出生并入住NICU且无接受母亲自身母乳(MOM)禁忌证的婴儿。收集了整个NICU住院期间MOM、巴氏消毒捐赠母乳(PDM)和配方奶的每日摄入量。如果婴儿食用MOM和PDM,则归类为纯母乳喂养(EHM);如果食用配方奶以及MOM和/或PDM,则归类为混合喂养。收集了人口统计学、喂养结局、生长结局和新生儿疾病情况。

结果

在195名研究婴儿中,133名(32%)接受EHM。与混合喂养组相比,EHM组的MOM累积摄入量和百分比更高。EHM组向婴儿首次喂食初乳的时间早于混合喂养组(3.1天对4.9天,P = 0.013)。到出生后第二周时,EHM组100%的喂养为MOM,但混合喂养组接受的MOM最大比例为63%。两组在其他喂养或新生儿结局方面没有差异。

结论

EHM组比接受含配方奶混合喂养的组更早接受初乳,并且在出生后第二周时达到完全MOM喂养。这为解决NICU中早产儿母亲在出生后前两周的母乳供应挑战提供了机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8b4/12025542/c68fd530190a/children-12-00431-g001.jpg

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