Factors Associated with Low Volumes of Mother's Own Milk at Neonatal Intensive Care Unit Discharge of Very Low Birth Weight Infants-a Cohort Study.

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Breastfeeding Medicine Pub Date : 2024-06-01 Epub Date: 2024-04-17 DOI:10.1089/bfm.2023.0266
Mariana González de Oliveira, Desirée de Freitas Valle Volkmer, Arthur Pille, Jonas Wolf, Marôla Flores da Cunha Scheeren
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引用次数: 0

Abstract

Background: Mother's own milk (MOM) provides health benefits for infants with very low birth weight (VLBW). This study aimed to describe the incidence and factors associated with low volumes of MOM (<50% of total diet volume) at discharge for VLBW infants. Methods: A prospective cohort study of infants with VLBW and gestational age of <30 weeks, who survived to discharge and had no contraindication to MOM. We conducted bivariate analyses to investigate associations with the volume of MOM at discharge, using chi-square, t, and Mann-Whitney tests. All p-value analyses were two-tailed. The variables significantly associated with "low volumes of MOM" entered the multivariable analysis. Univariate and multivariate relative risk (confidence interval [CI] 95%) estimates were obtained from Poisson regression with a robust estimate of variance and controlled by the length of hospital stay. Results: Of 414 infants included and followed until discharge, 32.9% (n = 136) received less than 50% of the total daily volume of MOM. This outcome was associated with gestational age <28 weeks, lower birth weight, multiple births, developing bronchopulmonary dysplasia, and longer lengths of stay. After Poisson regression, low volumes of MOM at discharge were associated only with being born multiples (RR 2.01; CI 95% 1.53-2.64, p < 0.001) and with longer length of stay (RR 1.07; CI 95% 1.01-1.14, p = 0.01). Conclusions: Most VLBW infants were discharged home receiving predominantly MOM. Each neonatal intensive care unit (NICU) should acknowledge which clinical characteristics of mothers and VLBW infants are associated with difficulties maintaining MOM volumes until discharge.

极低出生体重儿在新生儿重症监护室出院时母乳量低的相关因素--一项队列研究。
背景:母乳(MOM)对极低出生体重儿(VLBW)的健康有益。本研究旨在描述低量母乳喂养的发生率和相关因素(方法:对 VLBW 和胎龄为 t 的婴儿进行前瞻性队列研究:对 VLBW 和胎龄为 t 的婴儿进行前瞻性队列研究,并进行 Mann-Whitney 检验。所有 p 值分析均采用双尾法。与 "MOM 量低 "明显相关的变量进入多变量分析。单变量和多变量相对风险(置信区间[CI] 95%)的估计值是通过泊松回归和稳健的方差估计得出的,并受到住院时间的控制。结果:在纳入并随访至出院的 414 名婴儿中,有 32.9% 的婴儿(n = 136)每天接受的 MOM 总量不足 50%。这一结果与胎龄(P < 0.001)和住院时间(RR 1.07; CI 95% 1.01-1.14, P = 0.01)有关。结论大多数超低体重儿出院回家时主要接受 MOM。每个新生儿重症监护病房(NICU)都应认识到,母亲和 VLBW 婴儿的哪些临床特征与出院前维持 MOM 容量的困难有关。
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来源期刊
Breastfeeding Medicine
Breastfeeding Medicine OBSTETRICS & GYNECOLOGY-PEDIATRICS
CiteScore
4.20
自引率
11.10%
发文量
130
审稿时长
6-12 weeks
期刊介绍: Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols. Breastfeeding Medicine coverage includes: Breastfeeding recommendations and protocols Health consequences of artificial feeding Physiology of lactation and biochemistry of breast milk Optimal nutrition for the breastfeeding mother Breastfeeding indications and contraindications Managing breastfeeding discomfort, pain, and other complications Breastfeeding the premature or sick infant Breastfeeding in the chronically ill mother Management of the breastfeeding mother on medication Infectious disease transmission through breast milk and breastfeeding The collection and storage of human milk and human milk banking Measuring the impact of being a “baby-friendly” hospital Cultural competence and cultural sensitivity International public health issues including social and economic issues.
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