FEEDING STRATEGIES FOR LOW BIRTH WEIGHT INFANTS II

我们最初研究的数据表明，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发育有显著影响。这项拟议的研究将在一项随机试验中调查迟发性败血症和/或NEC的发生率和住院时间，这两项试验既包括喂养添加强化巴氏杀菌供体母乳或早产配方奶粉的早产儿的随机试验，也包括在强化母乳和早产配方奶粉之间的非随机比较。将测量一种将母乳喂养与较低感染风险联系起来的潜在机制，即母体病原体特异性功能性抗体滴度。这些婴儿将被跟踪3年，以确定住院期间喂养母乳的长期后遗症。由于许多母亲未能提供足够的牛奶来满足婴儿的需求，将对母亲进行研究，以确定减压方法对牛奶产量的影响。将评估母婴皮肤接触的常见托儿所做法对母体功能性抗体效价和产奶量的影响。德克萨斯儿童医院托儿所的婴儿如果怀孕不到30周，将被纳入其中，这是患晚发性败血症和/或NEC风险最高的群体。我们用强化母乳这个术语来表示添加了蛋白质、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.