Abstract: Objective To explore the effects of different milk feeding pattern on the growth and development of preterm infants. Method 247 cases of 800~1 500 g preterm infants from Jan.2011 to Dec.2015 were divided into mother breast milk group 78 cases (group A),the mother breast milk + human milk fortifier (HMF) 75 cases (group B),without mother breast milk accepting donor breast milk + HMF group 49 cases (group C) and without mother breast milk accepting the premature formula group 45 cases (group D).All infants were taken active feeding measures,with observation of full enteral feeding,physical growth and development,complications,the average length of hospital stay,etc. Results Mother breast milk group were lower than other three groups in physical development indexes such as the head circumference,weight and body length,time to enteral feeding at 100 Cal/(kg·d),regain birth weight time,while venous nutrition time was longer than other groups (P<0.05).There was no statistically significant difference between the other three groups.Preterm formula group had higher risk of infection within 1 year after discharge than other groups (P<0.05).There was no statistically significant difference in incidence of cholestasis,length of hospital stay,feeding intolerance and incidence of EUGR between the four groups (P>0.05). Conclusion The preterm birth mother milk + HMF is the best milk feeding pattern for preterm infants,followed by donor breast milk + HMF and preterm formula.   

Key words: preterm infant, breast feeding, physical growth, nutrition, human milk fortifier

摘要： 目的 探讨不同的奶方喂养对早产儿生长发育影响的研究。方法 选择本院新生儿科2011年1月-2015年12月247例800~1 500 g的早产儿,分为单纯生母母乳组78例(A组),生母母乳+母乳强化剂组75例(B组),无母乳愿意接受捐赠母乳者为捐赠母乳+母乳强化剂组49例(C组)和无母乳且不愿接受捐赠乳者予早产儿配方奶组45例(D组)。所有入选者均采取积极喂养措施,观察各组早产儿完全肠内喂养、体格生长发育、并发症发生情况、平均住院时间等项目。结果 头围、体重、身长等体格发育指标、喂养达100 Cal/(kg·d)时间、恢复出生体重的时间单纯生母母乳组较其他三组慢、静脉营养应用时间长,差异有统计学意义,其他三组之间差异无统计学意义;出院后1年内感染事件发生例次早产儿配方奶组较其他各组几率高,差异有统计学意义,其他三组之间差异无统计学意义;胆汁淤积发生率、住院时间、喂养不耐受、出院时宫外发育迟缓发生率等四组之间差异无统计学意义。结论 早产儿生母母乳加母乳强化剂为最佳奶方,其次为捐赠母乳加母乳强化剂,在两者均不能得到的情况下,早产儿配方奶也是为一种较好的奶方喂养方式。

关键词: 早产儿, 母乳喂养, 体格生长, 营养, 母乳强化剂