母乳喂养质量改进对极低和超低出生体重儿亲母母乳喂养率的影响

Effect of breastfeeding quality improvement on breastfeeding rate in very low birth weight and extremely low birth weight infants

摘要:

目的 探讨NICU 中母乳喂养质量改进措施对极低和超低出生体重儿亲母母乳喂养率的影响。方法 回顾性调查收集2014 年7 月至2015 年7 月收治的极低和超低出生体重儿（质量改进前组）以及实施母乳质量改进措施后的2015 年8 月至2016 年6 月的极低和超低出生体重儿（质量改进后组）资料。对两组患儿住院期间亲母母乳喂养情况（喂养率、喂养量、喂养时间）、静脉营养持续时间、达到全肠道喂养的时间，喂养不耐受发生率等指标进行比较。结果 实施质量改进后，亲母母乳喂养率和喂养量均明显增高，母乳强化剂添加时间、静脉营养时间、达全肠道喂养时间均较改进前提前，喂养不耐受的发生率较改进前有所改善，差异有统计学意义。结论 亲母母乳喂养质量改进措施可提高NICU 亲母母乳喂养率，改善早产儿消化系统相关并发症。

Abstract:

Objective To study the effect of breastfeeding quality improvement on the breastfeeding rate in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU). Methods A retrospective analysis was performed for the clinical data of VLBW and ELBW infants who were admitted from July 2014 to July 2015 (pre-improvement group) and those who were admitted from August 2015 to June 2016 after the implementation of breastfeeding quality improvement measures (post-improvement group). The parameters including condition of breastfeeding (breastfeeding rate, breastfeeding amount, and breastfeeding time), duration of parenteral nutrition, time to enteral feeding, and incidence of feeding intolerance were compared between the two groups. Results The implementation of breastfeeding quality improvement measures significantly increased breastfeeding rate and amount, significantly shortened time to addition of human milk fortifier, duration of parenteral nutrition, and time to enteral feeding, and significantly decreased the incidence of feeding intolerance. Conclusions Breastfeeding quality improvement measures can increase breastfeeding rate in the NICU and decrease gastrointestinal complications in preterm infants.