Amaniyo Lucy, Dektar Benbella, Nakibuuka Victoria, Nankunda Jolly, Opoka Robert, Kiguli Sarah
Department of Pediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
Department of Pediatrics and Child Health, Mulago Specialized Referral Hospital, Kampala, Uganda.
Front Pediatr. 2025 Jun 5;13:1558163. doi: 10.3389/fped.2025.1558163. eCollection 2025.
Over 60% of Very Low Birth Weight (VLBW) infants worldwide are born in Sub-Saharan Africa and South Asia. VLBW infants are born nutritionally disadvantaged, as they are suddenly and prematurely moved from a nutrient-rich to a nutrient-deficient environment. Therefore, appropriate feeding during the early neonatal period is essential for the survival and growth of VLBW infants admitted to the special care unit of a Ugandan tertiary referral hospital.
We conducted a prospective cohort study among VLBW infants admitted to the Special Care Unit at Kawempe National referral hospital in Kampala, Uganda. Stable infants with no gross abnormalities or in need of resuscitation were recruited on day two of life and followed up until day seven or to discharge or death, whichever came first. Data were collected on socio-demographic and clinical characteristics, including birth weight initiation of enteral feeds, type of feeds received, and method of feeding. Observed feeding practices were compared to recommended VLBW feeding standards for appropriateness. Infants were followed up until day 7 of life. Logistic regression analysis was used to determine the factors associated with sub-optimal feeding.
A total of 370 VLBW infants, with a mean gestational age of 32 weeks were enrolled. Overall, 333 (90%) had sub-optimal feeding and this was significantly associated with a sub-optimal rate of early weight change (growth velocity) [OR = 6.81, 95%, CI (2.74 to 16.97)]. Factors associated with sub-optimal feeding included: early initiation of enteral feeds [AOR = 11.03, 95%, CI (1.34 to 90.77)] and low scores on social support scale for the mother [AOR = 2.78, 95%, CI (1.14 to 6.82)].
There is a very high prevalence of sub-optimal feeding practices for VLBW infants in this population. This calls urgent need for improved feeding practices, including early enteral feeding. Future studies should explore the long terms effects of this early sub-optimal feeding practices on growth and development within the first 48 h, barring contraindications.
全球超过60%的极低出生体重（VLBW）婴儿出生在撒哈拉以南非洲和南亚。VLBW婴儿出生时营养状况不佳，因为他们突然过早地从营养丰富的环境转移到营养缺乏的环境。因此，在乌干达一家三级转诊医院的特殊护理病房中，早期新生儿期的适当喂养对于VLBW婴儿的生存和生长至关重要。
我们在乌干达坎帕拉卡韦姆佩国家转诊医院的特殊护理病房对VLBW婴儿进行了一项前瞻性队列研究。在出生后第二天招募生命体征稳定、无明显异常或无需复苏的婴儿，并随访至第七天或出院或死亡，以先到者为准。收集了社会人口学和临床特征数据，包括出生体重、肠内喂养开始时间、接受的喂养类型和喂养方法。将观察到的喂养方式与推荐的VLBW喂养标准进行适宜性比较。对婴儿随访至出生后第7天。采用逻辑回归分析确定与喂养不佳相关的因素。
共纳入370例平均胎龄为32周的VLBW婴儿。总体而言，333例（90%）喂养不佳，这与早期体重变化（生长速度）不佳显著相关[比值比（OR）=6.81，95%置信区间（CI）（2.74至16.97）]。与喂养不佳相关的因素包括：肠内喂养开始过早[AOR=11.03，95%CI（1.34至90.77）]和母亲社会支持量表得分低[AOR=2.78，95%CI（1.14至6.82）]。
该人群中VLBW婴儿喂养方式不佳的患病率非常高。这迫切需要改进喂养方式，包括早期肠内喂养。未来的研究应探讨在没有禁忌证的情况下，这种早期喂养方式不佳在出生后48小时内对生长发育的长期影响。
