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早期微量母乳喂养对低出生体重早产儿生长速率及产后抑郁的影响

Effect of early micro-breastfeeding on growth rate and postpartum depression in preterm infants with low-birth-weight.

作者信息

Chen Yu, Cai Sheng-Lan

机构信息

Department of Neonatology, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou 215200, Jiangsu Province, China.

出版信息

World J Psychiatry. 2025 Aug 19;15(8):108919. doi: 10.5498/wjp.v15.i8.108919.

Abstract

BACKGROUND

Premature infant formula is based on milk and contains energy, vitamins, Breast milk is rich in minerals, such as phosphorus and calcium, and proteins. Both can be used for nutritional support in preterm infants with low-birth-weight. However, their effects on the difference in infant growth rate and postpartum depression are still unclear.

AIM

To explore the effect of early micro-breastfeeding on the growth rate of preterm infants with low-birth-weight and maternal postpartum depression.

METHODS

Data of 68 preterm infants with low-birth-weight and their mothers admitted to the Department of Neonatology, Suzhou Ninth Hospital Affiliated to Soochow University, between January 2022 and December 2024, were retrospectively collected. The infants were divided into two groups according to the different enteral feeding methods in the early stage: Control group ( = 32 cases, premature infant formula feeding) and observation group ( = 36 cases, micro-breastfeeding, , exclusive breastfeeding, no mixed feeding). The baseline data; feeding status; gastrointestinal adverse reactions such as vomiting, gastric retention, and abdominal distension; growth rate (body weight, body length, and head circumference); and adverse events (infection, cholestasis, hyperbilirubinemia, and necrotizing enterocolitis) were compared between the two groups. Moreover, the maternal postpartum depression status of the two groups based of infants based on the Edinburgh postpartum depression scale (EPDS) was compared.

RESULTS

No significant difference in baseline data was found between the two groups ( > 0.05). The onset time of weight gain (6.49 ± 0.53 days 7.09 ± 0.61 days, < 0.001), time for complete meconium excretion (6.28 ± 0.92 days 8.31 ± 1.17 days, < 0.001), time for recovery to birth weight (8.81 ± 1.40 days 10.95 ± 1.64 days, < 0.001), and time to reach full enteral feeding (12.29 ± 2.08 days 15.48 ± 2.27 days, < 0.001) were compared between the observation and control groups. The incidence of vomiting, abdominal distension, and gastric retention was significantly lower in the observation group than in the control group, and the difference was significant ( < 0.05). The rates of the weight growth (15.88 ± 1.57 g/day 14.84 ± 1.51 g/day, = 0.007), head circumference (0.63 ± 0.08 cm/week 0.59 ± 0.05 cm/week, = 0.018), and length (0.80 ± 0.12 cm/week 0.73 ± 0.14 cm/week, = 0.029) were compared between the observation and control groups. On hospital admission of preterm infants with low-birth-weight, the mothers of the two groups did not show a significant difference in the EPDS scores for postpartum depression ( > 0.05). Preterm infants with low-birth-weight were hospitalized for 2 weeks, and the EPDS score for maternal postpartum depression was significantly lower in the observation group than in the control group (8.38 ± 1.47 9.49 ± 2.35, = 0.021).

CONCLUSION

Compared with preterm infant formula feeding, early micro-breastfeeding can more effectively promote the growth rate of preterm infants with low-birth-weight and reduce the gastrointestinal feeding intolerance and related complications, thereby alleviating mothers' concerns about their children and reducing the risk of postpartum depression.

摘要

背景

早产婴儿配方奶粉以牛奶为基础,含有能量、维生素、矿物质(如磷和钙)和蛋白质。母乳富含矿物质和蛋白质,两者均可用于低体重早产儿的营养支持。然而,它们对婴儿生长速度差异和产后抑郁症的影响仍不明确。

目的

探讨早期微量母乳喂养对低体重早产儿生长速度及产妇产后抑郁症的影响。

方法

回顾性收集2022年1月至2024年12月苏州大学附属苏州第九医院新生儿科收治的68例低体重早产儿及其母亲的数据。根据早期不同的肠内喂养方式将婴儿分为两组:对照组(n = 32例,早产婴儿配方奶粉喂养)和观察组(n = 36例,微量母乳喂养,即纯母乳喂养,无混合喂养)。比较两组的基线数据、喂养情况、呕吐、胃潴留和腹胀等胃肠道不良反应、生长速度(体重、身长和头围)以及不良事件(感染、胆汁淤积、高胆红素血症和坏死性小肠结肠炎)。此外,基于爱丁堡产后抑郁量表(EPDS)比较两组婴儿母亲的产后抑郁状况。

结果

两组基线数据无显著差异(P > 0.05)。比较观察组和对照组体重增加的开始时间(6.49 ± 0.53天对7.09 ± 0.61天,P < 0.001)、胎粪完全排出时间(6.28 ± 0.92天对8.31 ± 1.17天,P < 0.001)、恢复至出生体重的时间(8.81 ± 1.40天对10.95 ± 1.64天,P < 0.001)以及达到完全肠内喂养的时间(12.29 ± 2.08天对15.48 ± 2.27天,P < 0.001)。观察组呕吐、腹胀和胃潴留的发生率显著低于对照组,差异有统计学意义(P < 0.05)。比较观察组和对照组的体重增长速度(15.88 ± 1.57克/天对14.84 ± 1.51克/天,P = 0.007)、头围(0.63 ± 0.08厘米/周对0.59 ± 0.05厘米/周,P = 0.018)和身长(0.80 ± 0.12厘米/周对0.73 ± 0.14厘米/周,P = 0.029)。低体重早产儿入院时,两组母亲的产后抑郁EPDS评分无显著差异(P > 0.05)。低体重早产儿住院2周时,观察组母亲产后抑郁的EPDS评分显著低于对照组(8.38 ± 1.47对9.49 ± 2.35,P = 0.021)。

结论

与早产婴儿配方奶粉喂养相比,早期微量母乳喂养能更有效地促进低体重早产儿的生长速度,降低胃肠道喂养不耐受及相关并发症,从而减轻母亲对孩子的担忧,降低产后抑郁症的风险。

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Preterm Infant Enteral Feeding Practices in Saudi Arabia: A Scoping Review.沙特阿拉伯早产儿肠内喂养实践:一项范围综述
Saudi J Med Med Sci. 2024 Oct-Dec;12(4):275-283. doi: 10.4103/sjmms.sjmms_637_23. Epub 2024 Oct 12.

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