[Effects of different feeding patterns on the growth and development of infants with very/extremely low birth weight]

Zhongguo Dang Dai Er Ke Za Zhi. 2018 Jul;20(7):572-577. doi: 10.7499/j.issn.1008-8830.2018.07.012.
[Article in Chinese]

Abstract

Objective: To investigate the growth and development of very low birth weight (VLBW)/extremely low birth weight (ELBW) preterm infants within the corrected age of 6 months and the effect of different feeding patterns on growth and development.

Methods: A total of 109 VLBW/ELBW preterm infants who were discharged from January 2016 to April 2017 and who had completed regular follow-up were enrolled, and their growth and development within the corrected age of 6 months were monitored. The Z-score method was used to evaluate physical indices and analyze the effect of different feeding patterns (breastfeeding group: breast milk + human milk fortifier; mixed feeding group: breast milk + preterm formula milk; artificial feeding: preterm formula milk) on growth and development.

Results: The peaks of weight-for-age Z-score, height-for-age Z-score, weight-for-height Z-score, and BMI-for-age Z-score occurred within the corrected age of 3 months, and the peak of head circumference-for-age Z-score occurred at the corrected age of 5 months. Growth deviation of the infants often occurred within the corrected age of 1-3 months. At the corrected age of 3 months, the breastfeeding group had significantly better body weight, height and head circumference growth than the mixed feeding group and/or the artificial feeding group (P<0.05). At the corrected age of 6 months, the breastfeeding group had significantly better head circumference and body length growth than the mixed feeding group and/or the artificial feeding group (P<0.05).

Conclusions: Growth deviation of VLBW/ELBW preterm infants often occurs within the corrected age of 1-3 months, suggesting that early individualized follow-up and nutritional guidance should be strengthened to reduce growth deviation. Maternal breastfeeding with the addition of human milk fortifier is the best feeding pattern for VLBW/ELBW preterm infants.

目的: 探讨极低/超低出生体重(VLBW/ELBW)早产儿纠正年龄6个月内生长发育情况及不同喂养方式对其生长发育的影响。

方法: 对2016年1月至2017年4月出院并按时完成随访的VLBW/ELBW早产儿109例进行纠正年龄6个月内的生长发育监测。采用Z评分法评价体格指标,并分析不同喂养方式(母乳喂养组:母乳+母乳强化剂;混合喂养组:母乳+早产儿配方奶;人工喂养组:早产儿配方奶)对其生长发育的影响。

结果: 年龄别体重Z积分、年龄别身长Z积分、身长别体重Z积分、体重指数Z积分的追赶高峰发生于纠正年龄3个月内;年龄别头围Z积分的追赶高峰发生于纠正年龄5个月。VLBW/ELBW早产儿的生长偏离多发生于纠正年龄1~3个月内。母乳喂养组体重、身长、头围的生长在纠正年龄3个月时均优于混合喂养组和/或人工喂养组(P < 0.05);母乳喂养组头围、身长的生长在纠正年龄6个月时均优于混合喂养组和/或人工喂养组(P < 0.05)。

结论: VLBW/ELBW早产儿的生长偏离多发生于纠正年龄1~3个月内,提示应加强早期个体化随访及营养指导以减少生长偏离的发生。亲母母乳喂养并添加母乳强化剂是VLBW/ELBW早产儿的最佳喂养方式。

MeSH terms

  • Body Height
  • Feeding Behavior*
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Extremely Low Birth Weight / growth & development*
  • Infant, Extremely Low Birth Weight / metabolism*
  • Infant, Newborn
  • Infant, Very Low Birth Weight / growth & development*
  • Infant, Very Low Birth Weight / metabolism*
  • Male

Grants and funding

江苏省妇幼健康科研项目(F201552)