早产儿母乳喂养调查分析

[目的]了解早产儿出院后4个月内母乳喂养状况及其影响因素.[方法]采用回顾性调查法,对2000年3月-2001年3月我院新生儿科收治的早产儿及其母亲进行调查.[结果]4个月早产儿的母乳喂养率为29.2%,其中纯母乳喂养率仅为7.7%.[结论]早产儿的母乳喂养率低,主要影响因素为母乳不足、早产儿吸吮力弱、母亲未掌握喂哺技巧、母婴分离时间较长.     

间歇泵奶在早产儿喂养中的应用

[目的]比较间歇泵奶与常规鼻饲早产儿喂养效果.[方法]将60例早产儿随机分为间歇泵奶组与常规鼻饲组,每组30例,用同一种配方奶喂养,记录患儿胃食管反流次数、残留次数及发生呼吸暂停或周期性呼吸次数.[结果]间歇泵奶组与常规鼻饲组残留率分别为4.75%和6.97%,间歇泵奶组发生呼吸暂停或周期性呼吸次数及胃食管反流率明显低于常规鼻饲组(P＜0.01).[结论]间歇泵奶喂养比常规鼻饲喂养胃食管反流率和残留率低,发生呼吸暂停或周期性呼吸少,安全可靠.     

间歇泵奶在早产儿喂养中的应用

[目的]比较间歇泵奶与常规鼻饲早产儿喂养效果。[方法]将60例早产儿随机分为间歇泵奶组与常规鼻饲组,每组30例,用同一种配方奶喂养,记录患儿胃食管反流次数、残留次数及发生呼吸暂停或周期性呼吸次数。[结果]间歇泵奶组与常规鼻饲组残留率分别为4.75%和6.97%,间歇泵奶组发生呼吸暂停或周期性呼吸次数及胃食管反流率明显低于常规鼻饲组（P〈0.01）。[结论]间歇泵奶喂养比常规鼻饲喂养胃食管反流率和残留率低,发生呼吸暂停或周期性呼吸少,安全可靠。     

提高早产儿母乳喂养率的干预研究

[目的 ]探讨提高早产儿母乳喂养率的干预措施。 [方法 ]对 2 0 0 0年 3月— 2 0 0 1年 3月我院收治的 13 0例早产儿出院后 4个月内母乳喂养状况进行调查 ,找出影响母乳喂养的因素 ,并制订干预措施。对 2 0 0 2年 1月— 2 0 0 2年 12月收治的 15 0例早产儿的及母亲进行干预。 [结果 ]干预后 4个月早产儿的母乳喂养率由干预前的 2 9.2 %提高到 88.0 %。 [结论 ]护理干预能提高早产儿的母乳喂养率。     

汕头市纯母乳喂养状况及影响因素的调查

目的 了解汕头市社区中分娩方式、胎儿孕周及婴儿母亲职业对纯母乳喂养时间的影响.方法 在汕头市金平、龙湖、濠江、潮阳、潮南5个社区中,每个社区抽取200名10个月～2岁婴儿的母亲进行问卷调查,共发出调查表1 000份.收回有效问卷972份.结果 婴儿纯母乳喂养率为94.8%,出生后4个月内纯母乳喂养率为62.4%,顺产者纯母乳喂养时间为(4.14±0.32)个月,剖宫产者为(3.04±0.30)个月;足月产儿纯母乳喂养时间为(4.32±0.24)个月,早产儿为(3.15±0.19)个月,非职业妇女纯母乳喂养时间为(4.04±0.23)个月,职业妇女为(3.11±0.2)个月.结论 顺产儿纯母乳喂养时间大于剖宫产儿;足月产儿纯母乳喂养时间大于早产儿;母亲为职业妇女者纯母乳喂养时间较非职业妇女者短.分娩方式、胎儿孕周及婴儿母亲职业均能影响出生后4个月内纯母乳喂养率.     

短期去乳糖奶粉喂养方法对新生儿腹泻的效果

目的：探讨短期去乳糖奶粉喂养方法对新生儿腹泻的效果。方法选取2013年3月—2014年2月腹泻患儿140例，按随机数字表法随机分为观察组和对照组各70例，观察组采用短期去乳糖奶粉喂养，对照组采用长期去乳糖奶粉喂养。比较两组患儿治疗效果、胃肠道症状、体质量增长与喂养耐受情况。结果观察组患儿痊愈51例，有效17例，无效2例；对照组痊愈47例，有效20例，无效3例，差异无统计学意义（Z＝0．758，P＝0．366）。观察组患儿平均体质量增长（34．30±7．35）g／（kg· d），平均摄入奶量（105．37±24．02）ml／（kg· d），优于对照组的（24．29±8．06）g／（kg· d），（97．21±21．66）ml／（kg· d），差异有统计学意义（t值分别为2．809，3．161；P＜0．05）。观察组排便次数、呕吐、腹胀、胃潴留发生例数均少于对照组，差异有统计学意义（P＜0．05）。结论腹泻新生儿采取短期去乳糖奶粉喂养方式既符合婴幼儿的生长发育特点，又可以维持其免疫功能的平衡，且经济实惠，值得在临床推广。     

Blood biochemical profile of very preterm infants before and after trophic feeding with exclusive human milk or with formula milk

ObjectivesTo determine whether feeding type of trophic feeds affect haematological and biochemical markers in the very preterm infant.Design and methodsFifty-six very preterm infants were enrolled in this retrospective study (30 infants were included in the only human milk-fed group and 26 in the formula-fed group). Routine haematological and biochemical variables were collected in both groups on days 1 and 4 of life and fourteen serum markers were measured.ResultsThere were no significant differences between the two groups before starting trophic feeds. After starting trophic feeds, sodium and lactate levels were significantly higher in the human milk-fed group compared with those measured in the formula-fed group.ConclusionThe study demonstrates that supplementation of minimal enteral feeding with human milk does affect biochemical profiles in very preterm infants. Small amounts of enteral feedings of formula and/or human milk may result in different metabolic responses; these differences are reflected by different serum biochemistries.     

NICU母乳和配方乳喂养管理的现况调查

目的 了解国内新生儿重症监护病房（neonatal intensive care unit,NICU）母乳和配方乳的管理现状及存在的问题。 方法 便利选取国内53所医院的NICU进行问卷调查,问卷共48个问题,内容包括母乳/配方乳管理支持系统、乳制品的来源与筛选、乳制品的管理、质量控制、喂养相关健康宣教和指导。 结果 53所医院NICU的母乳喂养率为（62.1±31.5)%;母乳和配方乳管理支持系统不完善,66.0%的医院无吸乳室、81.1%不提供母乳采集设备、75.5%未完全开放探视、92.5%无母乳库、60.4%未开展家庭参与式护理; 乳制品的来源的筛选方面,15.1%的NICU不接收母乳、42.2%不能随时接收母乳,母乳的筛选无统一标准,28.9%常规检测母乳巨细胞病毒,配方乳来源和种类各异;各NICU乳制品的管理存在不同程度的不规范,11.1%不具有冰箱保存母乳的条件、5.7%使用微波炉加热配方乳、4.4%巴氏消毒亲母母乳;质量控制措施不完善,分别有18.9%和6.7%的NICU对母乳和配方乳不登记、8.9%和3.8%无母乳喂养的病历记录和冰箱温度监测记录、17.0%由聘用护士以外的人员配奶;32.1% NICU宣教内容不全面,母乳喂养相关宣教不系统。 结论 各医院母乳和配方乳管理差异较大,且有相当一部分不够规范,应参照现有指南,加强NICU母乳和配方乳喂养管理,并制订适合我国国情的相关指南。     

Breast feeding in Cambridge, England: factors affecting the mother''s milk supply

Mothers breast feeding 2 weeks after delivery were studied. One group (106 mothers) were advised to 'eat for two' during lactation to sustain their milk supply. They were compared at 3 months with a control group of 152 mothers. At 3 months only half as many advised group mothers had weaned their babies due to insufficient milk as control mothers. The numbers weaning for other reasons were similar in both groups. More breast feeding mothers reported an increased appetite during lactation than did mothers who had changed to artificial feeding. Smokers were more likely to have given up breast feeding between 2 weeks and 3 months than non-smokers but smoking was not associated with any particular weaning reason. Women taking a contraceptive pill during lactation more often experienced a diminution of milk supply than non-pill-takers. Sustained lactation benefits the mother since those who were still breast feeding were less likely to suffer from depression or fatigue at 3 months, and were more likely to have lost weight. The early introduction of solids was less frequent among infants being breast fed at 3 months.     

Postnatal longitudinal reference growth of very preterm infants on exclusive human milk feeding till discharge

Background and objectivesGrowth measurements help to confirm an infant's healthy development and also help to identify early, potential health or nutritional problems. Appropriate Growth is also a criteria for early discharge of very preterm infants from NICU. To identify the infants who have growth faltering, we need to monitor the anthropometry regularly and compare with a local standard. Currently there is no best strategy of monitoring growth in VLBW infants. Objective of this study is to assess postnatal longitudinal growth for very preterm infants on Exclusive human milk feeding till discharge.Materials and methodsAll newborns with gestation <33 weeks at birth and admitted to the NICU included in this study. Those with major malformations, death before discharge and babies transferred to another hospital for care before 7 days were excluded. Nutritional and fluid management of all enrolled infants was guided by a nutritional protocol elaborating on both parenteral nutrition and enteral nutrition. All enrolled infants were on exclusive human milk (mothers own milk or donor human milk) till hospital discharge. All the discharged enrolled infants were followed up in the high risk follow up clinic weekly till the infant reached a post-menstrual gestational age of 37–40 weeks. Post-natal growth charts for each gestational age group was created using polynomial regression and linear regression.ResultsDuring the study period a total of 398 eligible infants were admitted to the neonatal units. After excluding 76 infants (36 died in hospital, 40 infants got shifted to another hospital before complete care), 322 infants were eligible for growth assessment. The average time to reach full feeds was 7.7 ± 5.2 days and time to regain birth weight was 12.2 ± 4.8 days. The average weight gain from time to regain birth weight till hospital discharge and till last PMA was 17.6 ± 16 gm/kg/day and 19.8 ± 8 gm/kg/day respectively. The rate of growth for length and head circumference in hospital and till last PMA was 0.8 ± 1 cm/week, 0.7 ± 0.4 cm/week and 0.38 ± 0.8 cm/week, 0.55 ± 0.7 cm/week respectively. The rate of growth in weight, length and head circumference differed significantly among the gestational age groups as shown in Charts.ConclusionInfants with exclusive fortified human milk feeding had growth rate very similar to in-utero growth from time to regain birth weight till hospital discharge or till last PMA at follow up.     

极低出生体重儿微量泵持续泵奶喂养的效果观察

[目的]观察极低出生体重儿微量泵持续泵奶喂养效果。[方法]将120例极低出生体重儿随机分成两组。实验组62例,予微量泵持续泵奶;对照组58例,常规3 h间歇自胃管注入奶液。[结果]实验组达到足胃肠喂养时间、静脉营养时间、恢复进食时间、住院时间均短于对照组,喂养不耐受发生率低于对照组,两组比较差异有统计学意义(P<0.05)。[结论]应用微量泵持续泵奶,可降低喂养不耐受发生率,有效促进胃肠喂养的建立,缩短住院日。     

极低出生体重儿微量泵持续泵奶喂养的效果观察

[目的]观察极低出生体重儿微量泵持续泵奶喂养效果。[方法]将120例极低出生体重儿随机分成两组。实验组62例,予微量泵持续泵奶;对照组58例,常规3 h间歇自胃管注入奶液。[结果]实验组达到足胃肠喂养时间、静脉营养时间、恢复进食时间、住院时间均短于对照组,喂养不耐受发生率低于对照组,两组比较差异有统计学意义（P〈0.05）。[结论]应用微量泵持续泵奶,可降低喂养不耐受发生率,有效促进胃肠喂养的建立,缩短住院日。     

发育支持护理与去乳糖奶粉喂养对剖宫产新生儿腹泻的治疗效果

目的探讨发育支持护理与去乳糖奶粉喂养对剖宫产新生儿腹泻的治疗效果。方法选择2013年7月至2015年2月在该院诊治的剖宫产新生儿腹泻患儿96例,根据随机数字表法分为治疗组与对照组各48例,两组均给予基础治疗,对照组给予发育支持护理,治疗组在对照组干预的基础上给予去乳糖奶粉喂养,两组治疗观察时间为7d。结果在治疗总有效率方面,对照组和治疗组分别为87.5%、97.9%,可见治疗组的疗效更好,两组差异有统计学意义(P0.05)。而在腹泻次数减少时间与大便成形时间方面,治疗组分别为(2.15±0.34)d和(42.45±7.24)h,而对照组分别为(3.68±0.24)d和(75.22±8.13)h,组间比较差异有统计学意义(P0.05)。治疗后治疗组的行为能力、原始反射、主动与被动肌张力和一般反应评分均明显高于对照组(P0.05)。而在患儿的智能和运动发育评分方面,治疗组得分分别为(107.39±15.22)分和(108.33±14.19)分,而对照组分别为(98.13±11.02)分和(96.29±13.74)分,组间比较差异有统计学意义(P0.05)。结论发育支持护理联合去乳糖奶粉喂养治疗剖宫产新生儿腹泻能有效促进临床症状恢复,有效改善患儿的神经行为能力,促进智能与运动能力发育,从而提高总体治疗效果。     

Beta2-microglobulin in human colostrum and milk: effect of breast feeding and physico-chemical characterization.

A statistically significant increase in beta2-microglobulin concentration in babies' sera after birth was accompanied by a decrease in beta2-microglobulin concentration in sera of nursing and non-nursing mothers; the amount by which babies' sera concentrations increased was not correlated with the decrease in serum or milk concentrations in their mothers. These results suggest that breast feeding does not affect the concentration of beta2-microglobulin in babies' sera. Furthermore, there was no relationship between serum beta2-microglobulin concentration of mothers and their babies at either point of observation. In all instances, however, the beta2-microglobulin concentration was significantly higher in infants' sera than in mothers' sera.     

The effect of breast milk temperature on feeding intolerance in tube-fed preterm infants: A randomized controlled study

AimThe aim of this study was to evaluate different methods of warming breastmilk in tube-fed preterm infants hospitalized in the neonatal intensive care unit.MethodThis was a parallel, prospective and randomized-controlled study. The study sample comprised 48 preterm infants aged 30–34 weeks, including 24 infants in each group. The effects of two different methods of warming breastmilk on the variables related to feeding behavior, discharge time, and weight gain in tube-fed preterm infants were compared.ResultsThere were statistically significant differences between the groups regarding the infants' discharge days and gastric residuals (p < 0.05). The logistic regression analysis found significant relationships between the method of warming breastmilk and the infants' discharge times and gastric residual frequencies. The infants who were given conventionally warmed milk were found 2.4 times as likely to have a gastric residual as those given device-warmed milk (Exp(B)/OR = 2.405, CI = 1.66–2.98).ConclusionIt was determined that the infants in the interventional group had lower rates of gastric residual and were discharged more quickly. Therefore, it is necessary and beneficial to warm breast milk to a specific temperature.