Feeding practices and necrotizing enterocolitis.

Feeding practices and necrotizing enterocolitis.
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DOI:
10.1016/j.clp.2012.12.001
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发表时间:
2013-03
影响因子:
2.1
通讯作者:
Ambalavanan N
Ambalavanan N
中科院分区:
医学4区
文献类型:
--
作者:
Ramani M;Ambalavanan N

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坏死性小肠结肠炎(NEC)是一种多因素疾病,主要影响早产儿。与配方奶粉相比,母乳可降低NEC的发病率。喂养实践,如在逐渐增加喂养前进行最低限度肠内营养(与完全禁食相比)、早期引入喂养(在出生后第4天之前与之后相比)和更快地增加喂养(30-35 ml/kg/天与15-20 ml/kg/天相比)不会增加早产儿NEC的发生率。没有证据支持早产儿持续管饲优于间断管饲。在没有任何其他NEC临床和放射学证据的喂养不耐受的早产儿中,最低限度的肠内营养而不是完全暂停肠内喂养可能是一种替代方法。与基于牛的强化剂相比,基于人乳的强化剂可能会降低NEC的发生率,但需要进行更多的研究。
Necrotizing enterocolitis (NEC) is a multifactorial disorder that primarily affects premature infants. Human milk as compared to formula reduces the incidence of NEC. Feeding practices such as minimal enteral nutrition (versus complete fasting) before progressive advancement of feeds, early introduction of feeds (before day 4 of life as compared to later), and a more rapid advancement of feeds (30–35 ml/kg/day as compared to 15–20 ml/kg/day) do not increase the incidence of NEC in preterm infants. There is no evidence supporting continuous over intermittent tube feedings in preterm infants. In a feed-intolerant preterm infant without any other clinical and radiological evidence of NEC, minimal enteral nutrition rather than complete suspension of enteral feeding may be an alternative. Human milk-based fortifier as compared to bovine-based fortifier may reduce the incidence of NEC but additional studies are required.
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