Abstract:
The optimal method for human milk (HM) fortification has not yet been determined. This study assessed whether fortification relying on measured HM macronutrient content (Miris AB analyzer, Upsala, Sweden) composition is superior to fortification based on assumed HM macronutrient content, to optimize the nutrition support, growth, and body composition in infants born at <33 weeks\' gestation. In a mixed-cohort study, 57 infants fed fortified HM based on its measured content were compared with 58 infants fed fortified HM based on its assumed content, for a median of 28 and 23 exposure days, respectively. The ESPGHAN 2010 guidelines for preterm enteral nutrition were followed. Growth assessment was based on body weight, length, and head circumference Δ z-scores, and the respective growth velocities until discharge. Body composition was assessed using air displacement plethysmography. Fortification based on measured HM content provided significantly higher energy, fat, and carbohydrate intakes, although with a lower protein intake in infants weighing ≥ 1 kg and lower protein-to-energy ratio in infants weighing < 1 kg. Infants fed fortified HM based on its measured content were discharged with significantly better weight gain, length, and head growth. These infants had significantly lower adiposity and greater lean mass near term-equivalent age, despite receiving higher in-hospital energy and fat intakes, with a mean fat intake higher than the maximum recommended and a median protein-to-energy ratio intake (in infants weighing < 1 kg) lower than the minimum recommended.
摘要:
尚未确定人乳(HM)强化的最佳方法。本研究评估了强化是否依赖于测得的HM常量营养素含量(MirisAB分析仪,厄普萨拉,瑞典)根据假定的HM常量营养素含量,成分优于强化,为了优化营养支持,增长,妊娠<33周出生的婴儿的身体成分。在一项混合队列研究中,根据测量的含量喂养强化HM的57名婴儿与根据假定含量喂养强化HM的58名婴儿进行了比较,在28天和23天的中位数暴露中,分别。遵循ESPGHAN2010早产肠内营养指南。生长评估是基于体重,长度,和头围Δz分数,和各自的生长速度直到放电。使用空气置换体积描记术评估身体成分。基于测得的HM含量的强化提供了显着更高的能量,脂肪,和碳水化合物的摄入量,尽管体重≥1kg的婴儿蛋白质摄入量较低,体重<1kg的婴儿蛋白质能量比较低。根据测得的含量喂养强化HM的婴儿的体重增加明显更好,长度,头部增长。这些婴儿有显著较低的肥胖和更大的瘦体重近足月等效年龄,尽管接受了更高的住院能量和脂肪摄入量,平均脂肪摄入量高于建议的最大值,蛋白质/能量摄入量的中位数(体重<1kg的婴儿)低于建议的最小值。