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首页> 外文期刊>Journal of pediatric gastroenterology and nutrition >Growth and development of premature infants fed predominantly human milk, predominantly premature infant formula, or a combination of human milk and premature formula.
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Growth and development of premature infants fed predominantly human milk, predominantly premature infant formula, or a combination of human milk and premature formula.

机译：主要以人乳，主要为早产儿奶粉或人乳和早产儿奶粉混合喂养的早产儿的生长发育。

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BACKGROUND: In a recent meta-analysis, human milk feeding of low birth-weight (LBW) infants was associated with a 5.2 point improvement in IQ tests. However, in the studies in this meta-analysis, feeding regimens were used (unfortified human milk, term formula) that no longer represent recommended practice. OBJECTIVE: To compare the growth, in-hospital feeding tolerance, morbidity, and development (cognitive, motor, visual, and language) of LBW infants fed different amounts of human milk until term chronologic age (CA) with those of LBW infants fed nutrient-enriched formulas from first enteral feeding. METHODS: The data in this study were collected in a previous randomized controlled trial assessing the benefit of supplementing nutrient-enriched formulas for LBW infants with arachidonic acid and docosahexaenoic acid. Infants (n = 463, birth weight, 750-1,800 g) were enrolled from nurseries located in Chile, the United Kingdom, and the United States. If human milk was fed before hospital discharge, it was fortified (3,050-3,300 kJ/L, 22-24 kcal/oz). As infants were weaned from human milk, they were fed nutrient-enriched formula with or without arachidonic and docosahexaenoic acids (3,300 kJ/L before term, 3,050 kJ/L thereafter) until 12 months CA. Formula fed infants were given nutrient-enriched formula with or without added arachidonic and docosahexaenoic acids (3,300 kJ/L to term, 3,050 kJ/L thereafter) until 12 months CA. For the purposes of this evaluation, infants were categorized into four mutually exclusive feeding groups: 1) predominantly human milk fed until term CA (PHM-T, n = 43); 2) >/= 50% energy from human milk before hospital discharge (>/= 50% HM, n = 98); 3) < 50% of energy from human milk before hospital discharge (< 50% HM, n = 203); or 4) predominantly formula fed until term CA (PFF-T, n = 119). RESULTS: PFF-T infants weighed approximately 500 g more at term CA than did PHM-T infants. This absolute difference persisted until 6 months CA. PFF-T infants were also longer (1.0-1.5 cm) and had larger head circumferences (0.3-1.1 cm) than both PHM-T and >/= 50% HM infants at term CA. There was a positive association between duration of human milk feeding and the Bayley Mental Index at 12 months CA (P = 0.032 full and P = 0.073 reduced, statistical models) after controlling for the confounding variables of home environment and maternal intelligence. Infants with chronic lung disease fed >/= 50% HM until term CA (n = 22) had a mean Bayley Motor Index about 11 points higher at 12 months CA compared with infants PFF-T (n = 24, P = 0.033 full model). CONCLUSION: Our data suggest that, despite a slower early growth rate, human milk fed LBW infants have development at least comparable to that of infants fed nutrient-enriched formula. Exploratory analysis suggests that some subgroups of human milk fed LBW infants may have enhanced development, although this needs to be confirmed in future studies.
机译：背景：在最近的一项荟萃​​分析中，低出生体重（LBW）婴儿的母乳喂养与智商测试提高了5.2分。但是，在这项荟萃分析的研究中，使用了不再代表推荐做法的喂养方案（未加糖的人乳，术语配方）。目的：比较喂食到不同年龄母乳的LBW婴儿的生长，住院喂养耐受性，发病率和发育情况（认知，运动，视觉和语言），以及按年龄补充营养的LBW婴儿-从首次肠内喂养中获得的丰富配方。方法：本研究的数据是在先前的一项随机对照试验中收集的，该试验评估了花生四烯酸和二十二碳六烯酸对LBW婴儿补充营养丰富的配方食品的益处。婴儿（n = 463，出生体重，750-1,800克）来自智利，英国和美国的托儿所。如果在出院前喂了母乳，则将其强化（3,050-3,300 kJ / L，22-24 kcal / oz）。当婴儿从人乳中断奶时，他们会喂食富含或不含花生四烯酸和二十二碳六烯酸的营养配方食品（足月前为3,300 kJ / L，之后为3,050 kJ / L），直到大约12个月。给予配方奶粉喂养的婴儿营养丰富的配方奶粉，添加或不添加花生四烯酸和二十二碳六烯酸（至足月为3,300 kJ / L，此后为3,050 kJ / L），直到大约12个月。出于评估的目的，将婴儿分为四个互斥的喂养组：1）以母乳喂养直到CA龄（PHM-T，n = 43）。 2）出院前从母乳中获得> / = 50％的能量（> / = 50％HM，n = 98）; 3）出院前<50％来自人乳的能量（<50％HM，n = 203）;或4）主要以配方奶粉喂养直到CA期（PFF-T，n = 119）。结果：足月CA的PFF-T婴儿比PHM-T婴儿重约500 g。这种绝对差异一直持续到CA 6个月。在足月CA时，PFF-T婴儿也比PHM-T和> / = 50％HM婴儿更长（1.0-1.5 cm），头围更大（0.3-1.1 cm）。在控制了家庭环境和孕产妇智力的混杂变量之后，母乳喂养的持续时间与CA 12个月时的贝利精神指数呈正相关（P = 0.032饱食，P = 0.073减少，统计模型）。在CA足月（> 22）喂养≥50％HM的慢性肺疾病婴儿，CA 12个月时的平均Bayley运动指数比婴儿PFF-T高（n = 24，P = 0.033完整模型） ）。结论：我们的数据表明，尽管早期生长速度较慢，但​​以人乳喂养的LBW婴儿的发育至少与以营养丰富的配方奶喂养的婴儿相当。探索性分析表明，用人乳喂养的LBW婴儿的某些亚组可能具有增强的发育，尽管这需要在未来的研究中得到证实。

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