Pereira G R
Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, USA.
Clin Perinatol. 1995 Mar;22(1):61-75.
In summary, the nutritional care of extremely premature babies includes special attention to glucose homeostasis and fluid and electrolyte balance in the immediate postnatal period. Parenteral nutrition should be started routinely on the 2nd or 3rd day of life, if the infant is metabolically stable, and continued until the infant is receiving sufficient enteral feedings to promote growth. If not clinically contraindicated, minimal enteral feedings should be started before the end of the first week of life. The decision to either advance or maintain minimal enteral feedings at a constant level should take into account the clinical status of the infant. Fortified preterm human milk is the preferred feeding and premature infant formulas, the best substitute. Multivitamin supplements may be necessary, depending on formula intake. Iron supplements can be initiated as early as 2 weeks of age and high levels of intake appear to be necessary during erythropoietin therapy.
总之，极早产儿的营养护理包括在出生后即刻特别关注葡萄糖稳态以及液体和电解质平衡。如果婴儿代谢稳定，应在出生后第2天或第3天常规开始肠外营养，并持续至婴儿接受足够的肠内喂养以促进生长。如果没有临床禁忌证，应在出生后第一周结束前开始少量肠内喂养。决定增加或维持少量肠内喂养在恒定水平时应考虑婴儿的临床状况。强化早产儿母乳是首选喂养方式，早产儿配方奶是最佳替代品。根据配方奶摄入量，可能需要补充多种维生素。铁补充剂可早在2周龄时开始，并且在促红细胞生成素治疗期间似乎需要高摄入量。
