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极早产儿的母乳常量营养素的摄入

时间:2016-01-04 16:40:02 阅读数:1668

Intake and Macronutrient Content of Human Milk Given to Extremely Preterm Infants

Elisabeth Stoltz Sjöström, RD

Inger Öhlund, PhD, RD

Andreas Tornevi, MSc

Magnus Domellöf, MD, PhD



Background

Human milk (HM) is the preferred basis of nutrition for infants, including those born prematurely. Information on HM macronutrient content is necessary to optimize nutritional support of preterm infants.

Objectives

This study aimed to describe the types and amounts of enteral feeds given to Swedish extremely preterm infants during hospitalization and to investigate the energy and macronutrient contents in HM given to these infants.

Methods

A population-based study of Swedish extremely preterm infants (n = 586) born before 27 gestational weeks was conducted. Data on ingested volumes of different milk during hospitalization and analyses of macronutrient content in HM samples were obtained from hospital records. Nutritional content of HM was determined by mid-infrared spectrophotometry analysis.

Results

During the first 4 weeks of life, 99% of the infants were exclusively fed HM, and at 4 weeks of life, 70% of the infants received only mother’s own milk (MOM). Nutritional content in 821 MOM samples was analyzed. Protein content in MOM decreased significantly from 2.2 to 1.2 g/100 mL during the first 112 postpartum days, whereas fat and energy content were highly variable within and between MOM samples. In addition, 354 samples of donor milk were analyzed. Content of protein, fat, and energy in pooled donor milk (n = 129) was lower compared to single donor milk.

Conclusion

Swedish extremely preterm infants receive MOM to a large extent during hospitalization. Protein, carbohydrates, and energy in MOM changed significantly with time. Weekly analyses of MOM during the first month of lactation would allow more individualized nutritional support for these vulnerable infants.


Published online before print August 12, 2014, doi: 10.1177/0890334414546354

J Hum Lact November 2014 vol. 30 no. 4 442-449



极早产儿的母乳常量营养素的摄入

背景

母乳(HM)是婴儿营养的基础,包括早产儿。母乳中的常量营养元素的信息内容对于早产婴儿营养支持是必要的。

目的

本研究旨在描述瑞典的极早产儿住院期间的肠内营养类型和数量,探讨给这些婴儿的母乳中能量和常量营养元素含量。

方法

以瑞典在27孕周前出生的极重度早产儿(n=586)人群为基础。在医院住院期间获得的样本,母乳中常量营养元素含量的分析和摄入量。

结果

在产后四周内,99%的婴儿专门给予母乳;和产后四周内,70%婴儿只有自己母亲的母乳(MOM)。对821个MOM乳汁样本的营养含量进行分析。在产后112天里,MOM的蛋白质含量显著降低,含量从2.2-1.2/100毫升,而脂肪和能量含量具高度差异性。此外,354例捐赠奶样本进行了分析,蛋白质,脂肪和能量的均量(n=129)相对低于单一捐赠者奶水。

结论

瑞典极早产儿住院期间很大程度的接受该早产儿妈妈的母乳。蛋白质、碳水化合物和能量能随时间发生明显变化。在产后第一个月,早产儿妈妈的母乳表现出对这些脆弱婴儿更多的个性化营养支持。



网络发表于2014年8月12日

由《Journal of Human Lactation》总第30期,2014年11月刊第442至449页发表



译者另注,世卫组织于1961年建议,早产儿的概念应为胎龄<37周出生的新生儿,而出生体重<2500g的婴儿统称为低出生体重(LBW)儿。此外,将出生体重在1000g〜1499g的早产儿称为极低出生体重(VLBW),出生体重在<1000g者称为超低出生体重(ELBW)儿。而本文仅指在瑞典2004年四月至2007三月,在新生儿监护病房内收集到的586位婴儿,而这些婴儿都是出生孕周在25.3± 1.1周,同时出生体重在763± 170g的超低出生体重儿。

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