Investigating donor human milk composition globally to develop effective strategies for the nutritional care of preterm infants: Study protocol.
Investigating donor human milk composition globally to develop effective strategies for the nutritional care of preterm infants: Study protocol.
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DOI：
10.1371/journal.pone.0283846
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
在全球范围内，每年有近 1500 万婴儿早产，对低收入和中等收入国家的影响尤为严重。在缺乏母乳的情况下，世界卫生组织建议使用捐赠母乳 (DHM)，因为它可以预防坏死性小肠结肠炎（一种危及生命的肠道疾病）。 DHM 的使用在全球范围内不断增加，许多低收入和中等收入国家将捐赠母乳库纳入其公共卫生战略以降低新生儿死亡率，但人们对 DHM 的营养成分知之甚少。其他知识差距包括 DHM 成分如何受到母乳储存实践的影响，以及当 DHM 与市售强化剂一起使用时是否达到早产儿营养建议。我们与来自高、中、低收入环境的 8 个不同地区的母乳银行合作伙伴设计了一项多地点研究，该研究将检查和比较来自世界各地 600 名经批准的母乳银行捐赠者的母乳中的各种营养物质和生物活性因子，为 DHM 创建全面的、不同地区的营养成分。然后，我们将模拟 2 至 10 名捐赠者的随机汇集，以评估汇集作为母乳库管理 DHM 营养变异性的潜在策略的影响。最后，我们将评估市售强化剂与 DHM 一起使用时是否符合营养建议。我们预计这项研究的结果将改善全球范围内越来越多接受捐赠母乳的早产儿的营养护理。
Globally, almost 15 million infants are born prematurely each year, disproportionately affecting low and middle-income countries. In the absence of mother’s milk, the World Health Organization recommends using donor human milk (DHM) due to its protective effect against necrotizing enterocolitis, a life-threatening intestinal disorder. The use of DHM is increasing globally, with many low and middle-income countries integrating donor milk banks into their public health strategies to reduce neonatal mortality, yet very little is known about the nutritional composition of DHM. Additional knowledge gaps include how DHM composition is influenced by milk banking practices, and whether preterm nutrient recommendations are achieved when DHM is used with commercially available fortifiers. We designed a multi-site study with eight geographically diverse milk bank partners in high, middle, and low-income settings that will examine and compare a broad range of nutrients and bioactive factors in human milk from 600 approved milk bank donors around the world to create comprehensive, geographically diverse nutrient profiles for DHM. We will then simulate the random pooling of 2 to 10 donors to evaluate the impact of pooling as a potential strategy for milk banks to manage nutrient variability in DHM. Finally, we will evaluate whether commercially available fortifiers meet nutrient recommendations when used with DHM. We expect that results from this study will improve nutritional care globally for the growing number of preterm infants who receive donor human milk.
影响因子：
3.6
作者：
Ramirez, Carina B.;McCoy, Karli L.;Jacob, Rachel;Lavender, Elizabeth;Bonagurio, Krista;Guerra, Diana Anzueto;Karottakuttu, Simon;Gelfond, Jonathon;McCurnin, Donald;Blanco, Cynthia L.;Moreira, Alvaro G.
通讯作者：
Moreira, Alvaro G.