(1 280 ± 286) g; (1 436 ± 201) g

Transcription

1 259 ( ) : g 24 (, 11 ) (, 13 ) 50%, 100 ml / (kg d) FM85, ; (30.6 ± 2.9), (1 280 ± 286) g; (31.6 ± 1.9), (1 436 ± 201) g, 81.6%, d [18.9 vs 17.1 g / (kg d), P = 0.364] (1.16 vs 1.00 cm /, P = 0.308) (0.79 vs 0.61 cm /, P = 0.057),,,, [,2009,27(3): ] : ; ; ; ; : R722 : A : (2009) Application of human milk fortifier in breast-fed preterm infants WANG Chen, WANG Dan-hua (Department of Pediatrics, Peking Union Medical College Hospital, Medical Science Institute of China, Beijing , China) Abstract: Objective To evaluate the short term growth velocity, and nutritional status of breast-fed premature infants supplemented with powdered human milk fortifier by a prospective, controlled study. Methods Twenty four infants with a birth weigh g and gestational age 36 weeks were enrolled. They were divided into fortified human milk group (FHM group) and preterm formula group (control group). Premature infants in FHM group received human milk over 50% of total feeding volume and complementary preterm formula. Human milk started to be enriched with human milk fortifier (HMF)(FM85) when the feeding volume reached 100 ml / (kg d). Premature infants in control group were fed with only preterm formula. The comparison was made on growth rate, biochemical indices, enteric and parenteral nutrition requirements, and complications between these two groups. Results There were no significant differences in general characteristics or complications between FHM group (n = 11, average birth weight was g, gestational age was 30.6 weeks) and control group (n = 13, average birth weight was g, gestational age was 31.6 weeks). The average volume of human milk fed to the infants in FHM group was 81.6% of the total feeding volume during hospital stay. Human milk fortifier was added on 24.6 days of postnatal age, 34.1 weeks of corrected age. The average growth velocity of weight (18.9 vs 17.1 g / (kg d), P = 0.364), length (1.16 vs 1.00 cm / week, P = 0.308) and head circumference (0.79 vs 0.61 cm / week, P = 0.057) were similar in FHM group and control group. Serum urea nitrogen at discharge was comparable between two groups. Serum albumin, prealbumin and phosphate values were lower in the infants of FHM group than those of control group. Serum alkaline phosphatase and calcium levels were higher in FHM group. There was no significant difference in incidence of feeding intolerance, necrotizing enterocolitis ( NEC), and nosocomial infection between two groups. Conclusions Premature infants fed with fortified human milk grew similarly to those premature infants fed with preterm formula during hospital stay. (J Clin Pediatr,2009,27(3): ) Key words: premature infants; breast milk; human milk fortifier; nutrition; growth : : danhuawang10@126.com

2 ( 100 ml ),,, [1],, h [2] 80 kcal / (kg d),, 140 kcal / kg, [3] 4.9 g / kg [5] FM85,, [6] 1 170, mg / d, VitD 770 U / d 1 Ca < 1.9 mmol / L, :, 2 : 1 (ALB) (PA) (BUN) 1.1 (Ca) (P) (ALP) 24 h , 12 h NICU, 34, g 5 Apgar, 7 d ( :, 50%,,, ) 5 : ( ) (IVH) (NEC) : ( 1 / 3) 3 [4] FM85 (200 g / 1 g 70, / d, 3 d 2 : ) 48 h, (400 g /, ( ) ) CRP ~ 48 h I / T, < 20 ml / kg ml / (kg d) ln, [7] (0.5 g 20 ml ), 24 h (1 g 20 ml [g / (kg d)] = [1000 ln( - )] / ) ( - )

3 261 (cm / ) = ( - ) / FM85 2 ~ 3 d ( 20 ml (cm / ) = ( - ) 1 g FM85), 1 / SPSS 12.0, 1 / 3 ( 20 ml 0.33 g P < 0.05 FM85),, t Fisher's 15 d (ANCOVA) kcal / kg, 2 2.2, ( 4) (81.6 ± 19.9)%, 2.3 (24.6 ± 12.7) d, (34.1 ± 2.7) 11 ( 3) ALB PA P 10 BUN 2 3 4

4 Ca 5 2.4, NEC, ml 0.35 mg, 6 4 NEC ml mg 6 (n) ; 100 ml 1.44 mg [10, 11] 2,, 7 NEC [12] NEC 3.2, [8] (363 mosm / L) (255 mosm / L), 3, 3.1 [9] NEC 4 NEC NICU 2 5 d (, [2], 15 ~ 20 g / (kg d) ), 1 cm / 2 NEC, 2 NEC,, [8, 9] , 63.6% 84.6 % ( P = ( < ), : 1 mmol / L), [13, FM85 ( 5 g FM85 14] 1.3 mg ) BUN mmo / L,,,,

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