FEEDING STRATEGIES FOR LOW BIRTH WEIGHT INFANTS II

我们原始研究的数据表明，母乳摄入量对迟发性败血症和/或坏死性小肠结肠炎（NEC）的发生率、住院时间和早产儿的生长有显著影响。拟议的研究将调查迟发性败血症和/或NEC的发生率和住院时间，在一项随机试验中，喂养早产儿强化人乳补充强化巴氏消毒供体母乳或早产儿配方奶，在一项非随机比较中，强化人乳和早产儿配方奶。将测量母乳喂养与较低感染风险相关的一个潜在机制，即母体病原体特异性功能抗体滴度。对这些婴儿进行为期3年的随访，以确定住院期间母乳喂养的长期后遗症。由于许多母亲无法提供足够的乳汁来满足婴儿的需要，因此将对母亲进行研究，以确定减压方法对乳汁产量的影响。将评估母亲和婴儿之间皮肤接触的常见托儿所做法对母亲功能抗体滴度和产奶量的影响。来自德克萨斯儿童医院托儿所的婴儿如果小于30周妊娠期将被纳入研究，这一组发生迟发性败血症和/或NEC的风险最高。我们使用“强化母乳”一词是指添加了蛋白质、矿物质、维生素和葡萄糖聚合物的商业制剂的母乳。

Data from our original study suggest that the quantity of human milk consumed had a marked effect on the incidence of late-onset sepsis and/or necrotizing enterocolitis (NEC), the duration of hospitalization, and the growth of the premature infant. The proposed study will investigate the incidence of late-onset sepsis and/or NEC and duration of hospitalization in both a randomized trial of feeding premature infants fortified human milk supplemented with either fortified pasteurized donor human milk or preterm formula, and in a non-randomized comparison between fortified human milk and preterm formula. One potential mechanism to relate human milk feeding to a lower risk of infection, the maternal titer of pathogen-specific functional antibody, will be measured. The infants will be followed for 3 years to determine the long-term sequelae related to feeding human milk during hospitalization. Because of the failure of many mothers to provide sufficient milk to meet their infants' needs, mothers will be studied to determine the effect of stress reduction methods on milk production. The common nursery practice of skin-to-skin contact between mother and infant will be evaluated for its effect on maternal functional antibody titers and milk production. Infants from the nurseries at Texas Children's Hospital will be enrolled if they are less than 30 weeks gestation, the group with the highest risk of developing late-onset sepsis and/or NEC. We use the term fortified mother's milk to indicate mother's own milk to which a commercial preparation of protein, minerals, vitamins, and glucose polymers is added.