摘要
目的评估解放军总医院第五医学中心新生儿重症监护室中不同孕周、不同时期母乳样本的脂质及热卡含量,并探索分析母乳脂质及热卡含量与围生期母儿因素的相关性,为新生儿个体化喂养提供思路和方法。方法采用Creamatocrit动态母乳测定仪对解放军总医院第五医学中心183位新生儿重症监护室母亲的305份母乳样本进行脂肪及热卡检测,所有母乳样本均在采集后24 h内冷藏保存状态下送至新生儿科母乳库。母乳样本于37℃环境中复温30 min后由同一护士在同一环境下于每日上午10:00-11:00进行测定。采用SPSS软件17.0进行统计学分析,P<0.05为差异有统计学意义。结果183例患儿的305份母乳样本脂肪含量为(45.65±26.76)g/L,热卡含量为(762.61±206.64)kcal/L(1 kcal=4.184 kJ)。初乳、过渡乳及成熟乳脂肪(F=2.053,P=0.130)及热卡(F=0.830,P=0.437)含量之间差异均无统计学意义。不同孕周新生儿母亲初乳(脂肪:F=1.119,P=0.331,热卡:F=2.928,P=0.058)、过渡乳(脂肪:F=0.530,P=0.590,热卡:F=1.377,P=0.257)、成熟乳(脂肪:F=0.612,P=0.545,热卡:F=1.101,P=0.337)脂肪含量及热卡含量差异均无统计学意义。多重线性回归分析结果显示母亲是否合并孕期并发症是影响母乳脂质及热卡含量的重要因素,母亲孕期合并高血压是影响成熟乳脂质含量的重要因素。结论母乳中热卡的含量高于行业内默认的670 kcal/L,不同母乳样本中热卡及脂肪的含量差别极大,并且研究结果不同于当前成熟乳脂肪含量高于初乳的观点和经验,建议在测定母乳热卡及脂肪的含量后制定个体化的强化母乳喂养方案。母亲合并孕期并发症应作为早产儿母乳喂养方案制定的首要考虑因素,建议有孕期并发症的产妇动态监测母乳热卡及脂肪含量,并根据结果适当调整早产儿母乳喂养方案。
Objective To evaluate the lipid and calorie content in breast milk samples from neonatal intensive care unit of the Fifth Medical Center of Chinese People's Liberation Army General Hospital,and to explore the correlation between the lipid and calorie content of breast milk and perinatal factors,so as to provide ideas and methods for individualized feeding of neonates.Methods A total of 305 breast milk samples from 183 neonatal mothers in Fifth Me-dical Center of Chinese People′s Liberation Army were tested for fat and calorie by adopting Creamatocrit dynamic breast milk analyzer.All breast milk samples were sent to the breast milk bank of neonatal intensive care unit within 24 hours after collection and refrigeration.Breast milk samples were rewarmed at 37℃for 30 minutes and then determined by the same nurses in the same environment from 10:00 to 11:00 Am daily.SPSS 17.0 was used for statistical analysis and P<0.05 was used for statistical analysis.Results The fat content of 305 breast milk samples from 183 infants was(45.65±26.76)g/L and the caloric content was(762.61±206.64)kcal/L(1 kcal=4.184 kJ).There was no significant difference between colostrum,transitional milk and mature milk in terms of fat(F=2.053,P=0.130)and calorie(F=0.830,P=0.437)content.There was no significant difference in colostrum(fat:F=1.119,P=0.331,calorie:F=2.928,P=0.058),transitional milk(fat:F=0.530,P=0.590,calorie:F=1.377,P=0.257),and mature milk(fat:F=0.612,P=0.545,calorie:F=1.101,P=0.337)in terms of fat content and calorie content among different gestational weeks newborns.Multiple linear regression analysis showed that mothers with pregnancy complications were important factors affecting breast milk lipid and calorie content.Mothers with hypertension during pregnancy are important factors affecting the lipid content of mature milk.Conclusions Breast milk calorie content may be higher than the industry-standard 670 kcal/L,and Creamatocrit dynamic breast milk analyzer can be used to determine the content of breast milk calories an
作者
郭果
孙娟
高彦彦
刘鑫鑫
张雪峰
Guo Guo;Sun Juan;Gao Yanyan;Liu Xinxin;Zhang Xuefeng(Neonatal Disease Diagnosis and Treatment Center,Fifth Medical Center of Chinese Peoples′s Liberation Army General Hospital,Beijing 100039,China)
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2019年第18期1411-1414,共4页
Chinese Journal of Applied Clinical Pediatrics
关键词
母乳
脂质
热量
成分分析
Breast milk
Lipids
Calories
Composition analysis
