Use of donor human milk in nonhospitalized infants: An infant growth study.
Use of donor human milk in nonhospitalized infants: An infant growth study.
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DOI：
10.1111/mcn.13128
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发表时间：
2021-04
影响因子：
3.4
通讯作者：
Shenker N
中科院分区：
文献类型：
--
作者：
Bramer S;Boyle R;Weaver G;Shenker N
当母亲自己的乳汁（母乳）不可用或不足时，建议将供体母乳（DHM）作为低出生体重儿的下一个最佳替代品。DHM用于健康足月婴儿的使用正在增加，但生长和耐受性的证据有限。这项回顾性研究评估了社区中接受英国母乳银行DHM的足月婴儿的生长情况。联系了2017年至2019年期间接受DHM的婴儿的母亲（n = 49），其中31人（63.2%）同意参加。14名婴儿接受DHM作为其他饲料（母乳和/或婴儿配方奶粉）的补充，17名婴儿在母乳喂养不可能的情况下（范围：3-6周）只喂DHM。通过使用WHO婴儿生长标准推导z评分来评估生长，并与200名纯母乳喂养的婴儿进行比较。多变量回归分析显示，z评分与年龄之间以及体重与年龄之间均无喂养方法特异性相关性，这表明z评分和生长速度不受喂养专用饲料、补充DHM或专用DHM的影响。DHM耐受性良好，未发生导致提前停药的不良事件。补充DHM组后，63%的婴儿（5/8）的母亲没有母乳喂养的物理障碍，纯母乳喂养。这项新的研究报告了接受DHM作为唯一奶源或补充剂的健康非住院婴儿的充分生长结果。需要进行前瞻性研究，以确认DHM是否是社区足月婴儿的合适喂养替代品，最佳持续时间，以及DHM可用性对母乳喂养率和孕产妇心理健康的影响。DHM接受者通过导出z分数与世卫组织婴儿生长标准（世界卫生组织，2020年）进行比较。使用WHO Anthro Macro（世界卫生组织，2011）计算年龄别体重、年龄别身长和年龄别头围z评分; z评分是与WHO婴儿生长标准相比时婴儿人体测量的标准差，具有性别和年龄特异性。
When mother's own milk (MOM) is unavailable or insufficient, donor human milk (DHM) is recommended as the next best alternative for low birthweight infants. DHM use for healthy, term infants is increasing, but evidence for growth and tolerability is limited. This retrospective study evaluated growth in term infants in the community who received DHM from a UK milk bank. Mothers of infants receiving DHM between 2017 and 2019 were contacted (n = 49), and 31 (63.2%) agreed to participate. Fourteen infants received DHM as a supplement to other feeds (MOM and/or infant formula) and 17 were exclusively fed DHM where breastfeeding was impossible (range: 3–6 weeks). Growth was assessed by deriving z‐scores using the WHO standard for infant growth and compared with 200 exclusively breastfed infants. Multivariate regression analysis revealed no feeding method‐specific association between z‐score and age, nor between weight and age, suggesting that z‐scores and growth velocity were not affected by feeding exclusive MOM, supplemental DHM or exclusive DHM. DHM was well‐tolerated with no adverse events that led to early cessation. After receiving supplemental DHM group, 63% of infants whose mothers had no physical barrier to breastfeeding (5/8 infants) were exclusively breastfed. This novel study reports adequate growth outcomes of healthy nonhospitalized infants receiving DHM, either as the sole milk source or supplement. Prospective studies are needed to confirm whether DHM is a suitable feeding alternative for term infants in the community, optimal durations, as well as the impact of DHM availability on breastfeeding rates and maternal mental health. DHM recipients were compared with the who infant growth standard (World Health Organization, 2020) by deriving z‐scores. The WHO Anthro Macro (World Health Organization, 2011 ) was used to calculate weight‐for‐age, length‐for‐age and head circumference‐for‐age z‐scores; z‐scores are the standard deviation of an infant's anthropometric measurements when compared with the WHO standard for infant growth and are gender and age specific.
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