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早产儿母乳喂养

Authors
Steven A Abrams, MD
Nancy M Hurst, PhD, RN, IBCLC
Section Editor
Joseph A Garcia-Prats, MD
Deputy Editor
Alison G Hoppin, MD
Translators
王慧欣, 主任医师

引言

由于已证实母乳对婴儿和母亲的健康有益，母乳已被普遍认为是喂养所有婴儿的最佳选择。世界卫生组织(World Health organization, WHO)、美国儿科学会(American Academy of Pediatrics, AAP)、美国妇产科医师学会(American College of Obstetricians and Gynecologists, ACOG)和美国预防医学工作组(United States Preventive Services Task Force, USPSTF)均推荐，在出生后6个月期间婴儿应接受母乳喂养[1-5]。 (参见“Infant benefits of breastfeeding”和“母乳喂养的母体收益和经济收益”)

然而，脆弱新生儿(如，早产儿)的母亲会遇到多种母乳喂养障碍和挑战，从而导致早产儿的母乳喂养率较足月儿的低[5,6]。例如，在美国马萨诸塞州，母乳喂养启动率在足月儿、出生时胎龄32-36周的早产儿、出生时胎龄24-31周的早产儿中分别为77%、70%、63%[5]。这些结果强调，需要解决早产母婴双方存在的母乳喂养障碍，特别是由于人乳已被明确证实对这些婴儿有益。 (参见“早产儿的母乳喂养及母乳强化”，关于‘母乳的优点’一节)

早产儿的母乳喂养总结在此，其中包括应对早产母婴特有挑战的策略。母乳的营养成分、早产儿母乳强化、早产儿肠内喂养的方法，均将单独讨论。 (参见“早产儿母乳及早产儿配方奶的营养成分”和“早产儿的母乳喂养及母乳强化”和“早产儿肠内营养概述”)

对父母的支持

有强有力的证据表明，对所有新手父母进行产前及产后教育和支持性干预可提高母乳喂养率，具体内容将单独讨论。 (参见“母乳喂养：父母教育及支持”)

在新生儿重症监护室(neonatal intensive care unit, NICU)，为解决早产儿父母特殊的母乳喂养需求，需要为其提供更多的教育。在大多数情况下，早产的母亲还没有做出是否母乳喂养婴儿的最终决定，并且她们可能没有得到做出明智选择的必要信息。临床医务人员应告知其母乳的益处，包括纯母乳喂养的长期影响。在大多数情况下，当母亲了解到母乳的益处后，她们会选择母乳喂养婴儿，并愿意挤奶[7]。

                   

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Literature review current through: 2017-06 . | This topic last updated: 2017-03-28.
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