Koraszülöttek szoptatása

„A kenguruzó babák nyugodtabbak, egészségesebbek és jobban fejlődnek” – beszélgetés dr. Schill Beáta neonatológussal

Létezik egy módszer, amelyet a természet adott. Létezik egy orvos, akinek nem is életcélja, hanem inkább az élete, hogy minél több koraszülöttnek legyen esélye az egészséges életre. Egy tudományosan igazolt módszerről van szó, amelyet egyre több magyarországi koraszülött intenzív osztályon is használnak. De még mindig nem mindenütt. Dr. Schill Beáta, tavaly Aranyanyu-díat is nyert a munkájával, bátor nő, az elvei mellett kiálló ember, aki oroszlánként harcol azért, hogy a keze alatt cseperedő babák a lehető legjobb ellátásban részesüljenek. Jelenléte nyugalmat sugároz, hitet ad, és lássuk be, ez nem könnyű feladat a mai magyar egészségügyben. Rohr Linda beszélgetett vele a kenguruzás világnapja és a „kenguruverseny” alkalmából.

Greater Mortality and Morbidity in Extremely Preterm Infants Fed a Diet Containing Cow Milk Protein Products

Abrams SA1, Schanler RJ, Lee ML, Rechtman DJ.
Breastfeed Med. 2014 May 27.


Background: Provision of human milk has important implications for the health and outcomes of extremely preterm (EP) infants. This study evaluated the effects of an exclusive human milk diet on the health of EP infants during their stay in the neonatal intensive care unit.

Formula milk versus donor breast milk for feeding preterm or low birth weight infants.

Quigley MA, Henderson G, Anthony MY, McGuire W.
Cochrane Database Syst Rev. 2007 Oct 17;(4):CD002971.


BACKGROUND: When sufficient maternal breast milk is not available, the alternative sources of enteral nutrition for preterm or low birth weight infants are donor breast milk or artificial formula milk. Feeding preterm or low birth weight infants with formula milk might increase nutrient input and growth rates. However, since feeding with formula milk may be associated with a higher incidence of feeding intolerance and necrotising enterocolitis, this may adversely affect growth and development.

OBJECTIVES: To determine the effect of formula milk compared with donor human breast milk on growth and development in preterm or low birth weight infants.

Kangaroo mother care to reduce morbidity and mortality in low-birth-weight infants

Conde-Agudelo A, Belizán JM, Diaz-Rossello J.
Cochrane Database Syst Rev. 2011 Mar 16;(3):CD002771.


BACKGROUND: Kangaroo mother care (KMC), originally defined as skin-to-skin contact between a mother and her newborn, frequent and exclusive or nearly exclusive breastfeeding, and early discharge from hospital, has been proposed as an alternative to conventional neonatal care for low birthweight (LBW) infants.

OBJECTIVES: To determine whether there is evidence to support the use of KMC in LBW infants as an alternative to conventional neonatal care.

Expansion of the baby-friendly hospital initiative ten steps to successful breastfeeding into neonatal intensive care: expert group recommendations.

Nyqvist KH et al.
J Hum Lact. 2013 Aug;29(3):300-9.


In the World Health Organization/United Nations Children's Fund document Baby-Friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care, neonatal care is mentioned as 1 area that would benefit from expansion of the original Ten Steps to Successful Breastfeeding. The different situations faced by preterm and sick infants and their mothers, compared to healthy infants and their mothers, necessitate a specific breastfeeding policy for neonatal intensive care and require that health care professionals have knowledge and skills in lactation and breastfeeding support, including provision of antenatal information, that are specific to neonatal care.

Breastfeeding Management for the Late Preterm Infant

Practical Interventions for "Little Imposters"

Marsha Walker
Clinical Lactation 2010 1(1):22-26


Infants who are late preterm (34–36 weeks) may appear mature, but they are physiologically, metabolically and neurologically immature. Late preterm infants are at higher risk for a number of problems including poor feeding, jaundice, hospital re–admittance and potential breastfeeding failure. This article provides specific strategies for working with late preterm infants and avoiding these negative health outcomes.

‘Kangaroo mother care’ to prevent neonatal deaths due to preterm birth complications

Lawn JE, Mwansa-Kambafwile J, Horta BL, Barros FC, Cousens S.
Int J Epidemiol. 2010 Apr;39 Suppl 1:i144-54.


Background ‘Kangaroo mother care’ (KMC) includes thermal care through continuous skin-to-skin contact, support for exclusive breastfeeding or other appropriate feeding, and early recognition/response to illness. Whilst increasingly accepted in both high- and low-income countries, a Cochrane review (2003) did not find evidence of KMC’s mortality benefit, and did not report neonatal-specific data.

A csak humán tejet tartalmazó táplálék csökkenti a nekrotizáló enterokolitisz kockázatát a koraszülötteknél

NEW YORK (Reuters Health) Január 15. – Az extrém kis súlyú koraszülöttek kizárólag humán tej alapú táplálása csökkenti a nekrotizáló enterokolitisz előfordulását és súlyosságát a humán és tehéntejalapú kevert táplálással összehasonlítva – állítja egy új tanulmány.

An Exclusively Human Milk-Based Diet Is Associated with a Lower Rate of Necrotizing Enterocolitis than a Diet of Human Milk and Bovine Milk-Based Products

Sullivan S, Schanler RJ, Kim JH, Patel AL, Trawöger R, Kiechl-Kohlendorfer U, Chan GM, Blanco CL, Abrams S, Cotten CM, Laroia N, Ehrenkranz RA, Dudell G, Cristofalo EA, Meier P, Lee ML, Rechtman DJ, Lucas A.
J Pediatr. 2009 Dec 24. [Epub ahead of print]


Objective To evaluate the health benefits of an exclusively human milk–based diet compared with a diet of both human milk and bovine milk–based products in extremely premature infants.

Effect of Domperidone on the Composition of Preterm Human Breast Milk

Campbell-Yeo ML, Allen AC, Joseph KS, Ledwidge JM, Caddell K, Allen VM, Dooley KC.
PEDIATRICS Vol. 125 No. 1 January 2010, pp. e107-e114 (doi:10.1542/peds.2008-3441)


Objective Domperidone is increasingly prescribed to improve breast milk volume despite a lack of evidence regarding its effects on breast milk composition. We examined the effect of domperidone on the nutrient composition of breast milk.

Supporting Premature Infant Nutrition

Premature infants who receive human milk have the best outcomes; medically, nutritionally, and developmentally.

The Supporting Premature Infant Nutrition (SPIN) program was developed to address the challenges of helping mothers produce sufficient breastmilk for their premature infants, and to improve the manner in which Neonatal Intensive Care Units support optimal nutrition and growth in their most vulnerable population of patients.

Breastfeeding promotion for infants in neonatal units: a systematic review and economic analysis

Renfrew MJ, Craig D, Dyson L, McCormick F, Rice S, King SE, et al.

Health Technol Assess 2009;13(40).

Objectives: To evaluate the effectiveness and costeffectiveness of interventions that promote or inhibit breastfeeding or feeding with breastmilk for infants admitted to neonatal units, and to identify an agenda for future research.

Effects of Different CMV-Heat-Inactivation-Methods on Growth Factors in Human Breast Milk

Rangmar Goelz, Eva Hihn, Klaus Hamprecht, Klaus Dietz, Gerhard Jahn, Christian Poets,
and Martin Elmlinger
Pediatr Res 65: 458–461, 2009

Preterm infants can inoculate virulent cytomegalovirus (CMV) through their mothers’ raw breast milk. Complete virus inactivation is achieved only by heat treatment, but the effect on growth factors has never been assessed systematically.

Urinary tract infection in preterm infants: the protective role of breastfeeding

Levy I, Comarsca J, Davidovits M, Klinger G, Sirota L, Linder N.
Pediatr Nephrol. 2009 Mar;24(3):527-31.


Urinary tract infection (UTI) differs between preterm and older infants and children in terms of prevalence, clinical presentation, causative organism, and rate of underlying renal anomalies. Data on risk factors of UTI in preterm infants are limited. The aim of this study was to characterize UTI both clinically and microbiologically in premature infants and to define possible risk factors and the role of breastfeeding in its development.

Intestinal Permeability in Preterm Infants by Feeding Type: Mother’s Milk Versus Formula

Sarah N. Taylor, Laura A. Basile, Myla Ebeling, and Carol L. Wagner
BREASTFEEDING MEDICINE Volume 4, Number 1, 2009


Background and Objective: Intestinal permeability in preterm infants represents a critical balance between absorption of nutritional agents and protection from dangerous pathogens. This study identified the relationship between feeding type (human milk and formula) and intestinal permeability as measured by lactulose to mannitol ratio in preterm infants in the first postnatal month.

Role of human milk in extremely low birth weight infants' risk of necrotizing enterocolitis or death

J Meinzen-Derr, B Poindexter, L Wrage, A L Morrow, B Stoll and E F Donovan

Journal of Perinatology (2009) 29, 57–62

Objective: To determine the association between human milk (HM) intake and risk of necrotizing enterocolitis (NEC) or death among infants 401 to 1000 g birth weight.

Conclusion: These data suggest a dose-related association of HM feeding with a reduction of risk of NEC or death after the first 2 weeks of life among extremely low birth weight infants.

Teljes cikk

Oropharyngeal administration of colostrum to extremely low birth weight infants: theoretical perspectives

N A Rodriguez, P P Meier, M W Groer and J M Zeller

Journal of Perinatology (2009) 29, 1–7

Own mother's colostrum (OMC) is rich in cytokines and other immune agents that provide bacteriostatic, bacteriocidal, antiviral, anti-inflammatory and immunomodulatory protection against infection. OMC may be especially protective for the extremely low birth weight (ELBW) infant in the first days of life; however clinical instability typically precludes enteral feedings during this period.

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