新生儿重症监护室出院时纯母乳喂养是否足以维持极早产儿的生长和神经发育?

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Breastfeeding Medicine Pub Date : 2024-10-01 Epub Date: 2024-08-22 DOI:10.1089/bfm.2024.0206
Wenona Lok, David Aboudi, Jordan S Kase
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引用次数: 0

摘要

背景:纯母乳(EHM)饮食好处多多。在新生儿重症监护室(NICU)出院时,可能会建议前早产儿补充配方奶粉,以满足预期的代谢需求和热量目标。关于极早产儿(VPTIs)出院后的营养建议尚存在争议,因为母乳补充对长期生长、神经发育和慢性疾病的益处不一。目的:比较早产儿出院后的生长和神经发育情况:比较新生儿重症监护室(NICU)出院时喂食 EHM 和添加辅食/配方奶的前早产儿的生长和神经发育情况。材料和方法:地区新生儿随访计划对 VPTI 进行了一项回顾性队列研究。根据新生儿重症监护室出院时的饮食对患者进行分类:EHM饮食、混合饮食(EHM和配方奶)和纯配方奶饮食。根据新生儿重症监护室出院时的饮食类型,比较了新生儿首次随访和3岁时的生长百分位数。此外,还比较了 3 岁时用贝利婴儿发育量表第三版测量的神经发育结果。结果:在 835 名 VPTIs 中,新生儿首次随访时的体重百分位数与新生儿重症监护室出院时的三种饮食类型相似。158 名受试者在 3 岁时接受了神经发育评估;无论新生儿重症监护室出院时的饮食如何,受试者的人体测量和神经发育情况都相似。结论新生儿重症监护室出院时的 EHM 饮食适合支持婴儿期的生长以及 3 岁前的生长和神经发育。因此,这就提出了一个问题,即 VPTI 在出院时是否有必要进行常规营养补充。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Is an Exclusive Human Milk Diet at the Time of Neonatal Intensive Care Unit Discharge Adequate to Maintain Growth and Neurodevelopment among Very Preterm Infants?

Background: An exclusive human milk (EHM) diet has numerous benefits. Formula supplementation may be recommended for former preterm infants at the time of neonatal intensive care unit (NICU) discharge to meet perceived metabolic demands and caloric goals. Recommendations addressing postdischarge nutrition for very preterm infants (VPTIs) are controversial, as the benefits of human milk supplementation regarding long-term growth, neurodevelopment, and chronic conditions are mixed. Objective: To compare growth and neurodevelopment of former VPTI fed an EHM diet to a supplemented/formula diet at NICU discharge. Materials and Methods: A retrospective cohort study of VPTI was followed at the Regional Neonatal Follow-up Program. Patients were categorized by diet at NICU discharge: EHM diet; mixed diet (EHM and formula); and exclusive formula diet. Growth percentile ranks at the first neonatal follow-up visit and 3 years of age were compared by diet type at NICU discharge. Neurodevelopmental outcomes as measured by the Bayley Scales of Infant Development 3rd Edition at 3 years of age were also compared. Results: Among 835 VPTIs, weight percentiles at the first neonatal follow-up visit were similar between the three NICU discharge diet types. One hundred fifty-eight subjects received neurodevelopmental evaluations at 3 years of age; anthropometrics and neurodevelopment were similar irrespective of diet at NICU discharge. Conclusion: An EHM diet at NICU discharge is appropriate to support growth in infancy as well as growth and neurodevelopment through 3 years of age. Thus, this raises the question of whether routine nutritional supplementation is necessary for VPTIs at NICU discharge.

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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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