有喂养困难的早产儿出院时母亲自己喂奶和直接母乳喂养的相关因素:临床和研究意义。

IF 2.1 3区 医学 Q2 OBSTETRICS & GYNECOLOGY
Faith Bala, Enas Alshaikh, Sudarshan R Jadcherla
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引用次数: 0

摘要

背景:早产儿在母乳喂养(MOM)和直接母乳喂养(DBF)方面存在诸多障碍。目的:本研究旨在确定出现喂养困难的早产儿从新生儿重症监护室(NICU)出院时的母乳喂养和直接母乳喂养的相关因素。研究方法对转诊评估喂养困难并以全口喂养出院的 237 名早产儿的数据进行回顾性研究。通过二元和多元回归分析,研究了母婴特征和口服喂养里程碑与出院时 MOM 摄入量和 DBF 的关系。结果:35.4%的婴儿(n = 84)在出院时进行了MOM喂养。产妇年龄越大、未使用药物、每次口服全量(PO)和出院之间的间隔天数越少,出院时出现任何MOM喂养的几率就越高(均为P < 0.05)。在 84 名 MOM 喂养的婴儿中,4.76%(n = 4)为纯母乳喂养,而 39.3%(n = 33)出院时为部分 DBF。DBF婴儿出生体重较高,无胎龄偏小发生率,出生时呼吸支持和脑室内出血发生率较低,完全母乳喂养时月经后年龄(PMA)较低,从首次母乳喂养到完全母乳喂养的持续时间较短,出院时PMA较低(均为P < 0.05)。结论:我们发现,有喂养困难的早产儿在出院时减少了 MOM 和 DBF 的使用。在这种情况下,临床管理和研究宣传必须将重点放在有针对性的干预上,认识到适用于孕前、孕期、NICU 和出院后护理的重要可改变因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors Associated with Mother's Own Milk Feeding and Direct Breastfeeding at Discharge in Preterm Infants with Feeding Difficulties: Clinical and Research Implications.

Background: Prematurity presents numerous barriers to mother's own milk (MOM) feeding and direct breastfeeding (DBF). Aim: This study aimed to determine factors associated with MOM feeding and DBF at discharge from the neonatal intensive care unit (NICU) in preterm-born infants presenting with feeding difficulties. Methods: A retrospective study of data from 237 preterm-born infants referred for evaluation of feeding difficulties and discharged home on full oral feeds was examined. Maternal and infant characteristics and oral feeding milestones were examined for their association with MOM intake and DBF at discharge using bivariate and multivariate regression analyses. Results: MOM feeding at discharge occurred in 35.4% (n = 84) infants. The odds of any MOM feeding at discharge were higher with higher maternal age, absence of maternal substance use, and fewer days between full per oral (PO) and discharge (all, p < 0.05). Among the 84 MOM-fed infants, 4.76% (n = 4) were exclusively breastfed, whereas 39.3% (n = 33) were partially DBF at discharge. The DBF infants had higher birthweight, no incidence of being small for gestational age, lower incidence of respiratory support at birth and intraventricular hemorrhage, lower postmenstrual age (PMA) at full PO, shorter duration from first PO to full PO, and lower PMA at discharge (all, p < 0.05). Conclusion: We found reduced use of MOM and DBF among preterm-born infants with feeding difficulties at NICU discharge. Clinical management and research advocacy must focus on targeted interventions in this setting by recognizing significant modifiable factors applicable to prepregnancy, pregnancy, NICU, and postdischarge care.

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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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