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Seminars in Fetal & Neonatal Medicine最新文献

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Use of human milk and fortification in the neonatal intensive care unit. 在新生儿重症监护病房使用母乳和强化。
IF 2.9 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2025-05-13 DOI: 10.1016/j.siny.2025.101632
David H Adamkin
{"title":"Use of human milk and fortification in the neonatal intensive care unit.","authors":"David H Adamkin","doi":"10.1016/j.siny.2025.101632","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101632","url":null,"abstract":"<p><p>Human milk is the gold standard for the nutrition of very-low-birthweight (VLBW) infants. Pasteurized donor human milk (DM) should be provided for VLBW infants when own mother's milk (OMM) is not available. Prevention of Necrotizing enterocolitis (NEC) is an important short-term benefit associated with human milk feeding. Human milk alone does not meet the nutritional requirements for VLBW infants leading to nutritional inadequacy, postnatal growthfaltering,and risk of poor neurodevelopmental outcome. Human milk fortification with multicomponent fortifiers increases calories and provides additional protein and minerals and should minimize nutritional deficits. Human milk derived fortifiers (HMDF) provide an exclusive human milk diet but recent evidence to recommend their use over cow milk derived fortifiers is lacking. Individualized fortification using human milk analyzers in real time is an emerging practice that allows for a more personalized provision of nutrient needs.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101632"},"PeriodicalIF":2.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-discharge nutrition to optimize preterm infant short- and long-term outcomes. 出院后营养优化早产儿短期和长期结局。
IF 2.9 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2025-04-09 DOI: 10.1016/j.siny.2025.101637
Sarah N Taylor, Catherine O Buck
{"title":"Post-discharge nutrition to optimize preterm infant short- and long-term outcomes.","authors":"Sarah N Taylor, Catherine O Buck","doi":"10.1016/j.siny.2025.101637","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101637","url":null,"abstract":"<p><p>The preterm infant misses fetal nutrition, and the nutritional deficit is proportional to the degree of preterm birth with very preterm infants demonstrating the greatest need for supplemental nutrition to overcome deficiencies. Preterm infants' growth patterns are linked to both their risk for neurodevelopmental difficulties and to the development of obesity. Therefore, establishing healthy growth patterns by providing the best nutrition both in the hospital and post-hospital discharge is critical for long-term health. Despite numerous clinical trials, uncertainty persists as to the duration of nutritional supplement, the degree of benefit of maternal milk feedings, and the best short-term measures of growth and body composition to predict long-term outcomes. As more is learned about optimal post-discharge nutrition, it is very likely that best practice in post-discharge nutrition will include use of a standardized approach to deliver individualized care.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101637"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gastrointestinal (GI)-lung-brain axis. 胃肠道(GI)-肺-脑轴。
IF 2.9 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2025-04-09 DOI: 10.1016/j.siny.2025.101639
Catalina Bazacliu, Juan Carlos Roig, Josef Neu
{"title":"Gastrointestinal (GI)-lung-brain axis.","authors":"Catalina Bazacliu, Juan Carlos Roig, Josef Neu","doi":"10.1016/j.siny.2025.101639","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101639","url":null,"abstract":"<p><p>The GI tract-lung-brain axis refers to the communication network linking the gastrointestinal tract, central nervous system, and respiratory system. This axis is particularly significant in preterm neonates because their immune and nervous systems are undergoing rapid development and thus are susceptible to various conditions influenced by GI tract and lung microbiota that are key mediators in this axis. This communication network is connected via neural, hormonal, and immunological regulatory pathways, all of which are pivotal in disease pathogenesis and health. Here we provide a brief introduction to this axis along with interactive mechanisms and perturbations that can affect this system and the roles they play in health and disease.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101639"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Donor human milk pasteurization methods and the effect on milk components as they relate to Necrotizing enterocolitis. 供体母乳巴氏灭菌方法及其对坏死性小肠结肠炎乳成分的影响。
IF 2.9 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2025-04-09 DOI: 10.1016/j.siny.2025.101638
Laiken Price, Kelly A Orgel, Misty Good
{"title":"Donor human milk pasteurization methods and the effect on milk components as they relate to Necrotizing enterocolitis.","authors":"Laiken Price, Kelly A Orgel, Misty Good","doi":"10.1016/j.siny.2025.101638","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101638","url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) is an intestinal disease that predominantly occurs in preterm infants. While there are no definitive treatment options for NEC, the administration of human milk is protective against the development of NEC in preterm infants. However, human milk composition is highly dynamic, containing numerous bioactive components that can be affected by both maternal and perinatal factors. Furthermore, when maternal milk is unavailable, donor human milk, which goes through a rigorous preparation process including pooling and pasteurization, is used. The different pasteurization methods can have implications for the bioactive components of human milk. In this review, we explore the current literature surrounding the benefits of human milk in the prevention of NEC. We further review the bioactive components and the microbiome of human milk and the many factors that affect the diversity of milk content between human milk samples. Finally, we review the different methods of pasteurization and their effects on the components of human milk.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101638"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Human milk for preterm infants. 早产儿的母乳。
IF 2.9 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2025-04-09 DOI: 10.1016/j.siny.2025.101634
Neena Modi
{"title":"Human milk for preterm infants.","authors":"Neena Modi","doi":"10.1016/j.siny.2025.101634","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101634","url":null,"abstract":"<p><p>The term \"human milk\" conceals important differences between that from an infant's own mother and that obtained from a person or persons who have donated or sold their breast milk. These include differences in nutritional content, and a wide range of non-nutritional components that promote immune, metabolic, and brain development and have evolved over the course of time to transmit biological information from mother to infant. Human milk feeding to preterm babies also encompasses elements such as processing and storage, differences between feeding expressed breast milk versus suckling at the breast, and societal and economic considerations. Current evidence of clinical effectiveness of donated or commercial human milk, and whether macro and micronutrient supplementation are required indicates considerable uncertainty and the possibility of harm. Preterm nutrition is an emotive subject, but important evidence gaps need to be recognised, acknowledged, and addressed if the care of very preterm babies is to improve through a strong evidence-base.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101634"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Short- and longer-term growth and development of fat mass in preterm infants. 早产儿脂肪量的短期和长期生长和发展。
IF 2.9 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2025-04-09 DOI: 10.1016/j.siny.2025.101636
Shipra Jain, Belal N Alshaikh, Seham Elmrayed, Tanis R Fenton
{"title":"Short- and longer-term growth and development of fat mass in preterm infants.","authors":"Shipra Jain, Belal N Alshaikh, Seham Elmrayed, Tanis R Fenton","doi":"10.1016/j.siny.2025.101636","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101636","url":null,"abstract":"<p><p>Preterm infants typically experience faster growth rates than term-born infants, often doubling their weight in six to eight weeks. However, many face challenges leading to growth faltering and suboptimal neurodevelopment. To achieve optimal growth, these infants often require fortified breastmilk or high-nutrient formula. While meeting nutrition and growth targets are essential, concerns arise about rapid postnatal growth during their catch-up phase, particularly regarding increased body fat at term-corrected age, possibly increasing their risk for obesity and chronic health conditions later. However, evidence suggests that although preterm infants may have higher body fat at term-corrected age, this difference diminishes by three months corrected age, aligning more closely with term-born infants. Systematic reviews of more than 20,000 individuals observed that small for gestational age preterm infants do not have higher adiposity in childhood and adulthood; rather, they exhibit lower body mass indexes, waist circumferences, similar body and visceral fat and blood pressure compared to their appropriate for gestational age preterm-born peers. Therefore, it is reassuring that promoting early growth in preterm infants does not necessitate a trade-off when it comes to supporting long-term metabolic outcomes versus neurodevelopment. Healthcare providers should encourage a responsive feeding approach, even in preterm infants, guided by infants' physiological needs, hunger and satiety once they exhibit feeding cues. This approach respects the child's developmental needs and encourages healthy eating habits, fostering positive parent-child feeding relationships, and ultimately allowing the child to grow and develop to their full potential without compromising their long-term health outcomes.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101636"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Amino acids and protein for preterm infants: How much and for what? 早产儿需要多少氨基酸和蛋白质？
IF 2.9 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2025-04-09 DOI: 10.1016/j.siny.2025.101633
William W Hay
{"title":"Amino acids and protein for preterm infants: How much and for what?","authors":"William W Hay","doi":"10.1016/j.siny.2025.101633","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101633","url":null,"abstract":"<p><p>Protein and amino acids derived from protein digestion in the gastrointestinal tract or from intravenous infusions are fundamental for normal metabolism, growth, and neurodevelopmental outcomes in the fetus and the preterm infant of the same gestational age. Many studies support that at least 3.0-3.5 g/kg/day of protein or amino acids are needed to achieve normal nitrogen/protein balance and growth rates and the large fractional increase of lean mass in later gestation, either in the fetus or the preterm infant; this relationship is direct and linear. Faster growth rates in earlier gestation require more amino acids and protein than the late preterm or term infant. Protein synthesis and accretion also require sufficient energy, but above ∼120 kcal/kg/day, energy is largely diverted to fat production but not lean mass growth. Optimal IV amino acid solutions remain to be developed, and mature maternal milk and donor human milk require protein supplements to achieve appropriate protein balance and growth. Additional supplements of growth factors might augment increased protein intakes and fortifiers. While excess amino acid and/or protein intakes do not promote growth or development and might even be harmful, providing less than the amounts required guarantees poorer outcomes and should be avoided.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101633"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exclusive enteral nutrition in preterm infants: How early is too early? 早产儿独家肠内营养：多早算太早？
IF 2.9 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2025-04-09 DOI: 10.1016/j.siny.2025.101631
Ariel A Salas, Shalini Ojha
{"title":"Exclusive enteral nutrition in preterm infants: How early is too early?","authors":"Ariel A Salas, Shalini Ojha","doi":"10.1016/j.siny.2025.101631","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101631","url":null,"abstract":"<p><p>With the growing availability of maternal and donor milk, neonatal feeding practices are undergoing significant transformation. Increasingly, neonatal units are prioritizing exclusive enteral nutrition soon after birth, a shift that represents a substantial advance in neonatal care. However, critical questions remain regarding the implementation, safety, and long-term outcomes of this approach. This review consolidates the evidence supporting early and exclusive enteral nutrition, exploring its potential to redefine neonatal care practices, particularly in high-resource settings. By examining challenges such as variability in practices, resource constraints, and clinical decision-making during acute illness, this discussion aims to provide a roadmap for integrating these practices into routine care and advancing outcomes for preterm and vulnerable infants.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101631"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Introduction. 介绍。
IF 2.9 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2025-04-09 DOI: 10.1016/j.siny.2025.101630
David H Adamkin, William W Hay
{"title":"Introduction.","authors":"David H Adamkin, William W Hay","doi":"10.1016/j.siny.2025.101630","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101630","url":null,"abstract":"","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101630"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Parenteral nutrition for preterm infants: benefits and risks in 2025. 早产儿肠外营养：2025年的益处和风险
IF 2.9 3区 医学
Seminars in Fetal & Neonatal Medicine Pub Date : 2025-04-09 DOI: 10.1016/j.siny.2025.101635
Nicholas D Embleton, Chris H P van den Akker, Mark Johnson
{"title":"Parenteral nutrition for preterm infants: benefits and risks in 2025.","authors":"Nicholas D Embleton, Chris H P van den Akker, Mark Johnson","doi":"10.1016/j.siny.2025.101635","DOIUrl":"https://doi.org/10.1016/j.siny.2025.101635","url":null,"abstract":"<p><p>Parenteral nutrition (PN) has been a key component of neonatal care for preterm infants since the 1980's and provides macronutrients for growth, along with electrolytes, minerals, vitamins and trace elements. In this article we consider common issues with routine provision to very preterm infants including estimation of nutrient requirements, optimal starting doses of PN, rates of increase and maximum intakes. We consider monitoring strategies and outline common complications which may be serious and fatal. Finally, we consider risk-benefit ratios in different populations of preterm infants, and outline some of the major uncertainties in current practice.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101635"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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