vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v21i1/2384vsp-2835Research ArticleОРИГИНАЛЬНАЯ СТАТЬЯORIGINAL ARTICLEФакторы, ассоциированные с исключительно грудным вскармливанием поздних недоношенных детей в неонатальном стационаре: одномоментное исследованиеFactors Associated with Exclusive Breastfeeding of Late Preterm Infants in Neonatal Hospital: Cross-Sectional Studyhttps://orcid.org/0000-0002-4348-9251ПриходькоЕ. А.PrikhodkoEvgeniia A.

 Москва 

 Moscow 

https://orcid.org/0000-0002-8717-2539БеляеваИ. А.BelyaevaIrina A.

Беляева Ирина Анатольевна, доктор медицинских наук, профессор РАН, врач-неонатолог Морозовской ДГКБ ДЗМ, профессор кафедры факультетской педиатрии ПФ Российского национального медицинского университета им. Н.И. Пирогова, руководитель отдела преконцепционной, антенатальной и неонатальной медицины НИИ педиатрии и здоровья детей ЦКБ РАН

119049, Москва, 4-й Добрынинский пер., д. 1/9

 Moscow 

irinaneo@mail.ruhttps://orcid.org/0000-0001-5055-0885КругляковА. Ю.KruglyakovAndrey Yu.

 Москва 

 Moscow 

https://orcid.org/0000-0001-9092-6453МихееваА. А.MikheevaAnna A.

 Москва 

 Moscow 

ГоревВ. В.GorevValeriy V.

 Москва 

 Moscow 

Морозовская детская городская клиническая больница ДЗМРоссияMorozovskaya Children’s City HospitalRussian FederationМорозовская детская городская клиническая больница ДЗМ; НИИ педиатрии и охраны здоровья детей ЦКБ РАН; Российский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияMorozovskaya Children’s City Hospital; Research Institute of Pediatrics and Children’s Health in “Central Clinical Hospital of the Russian Academy of Sciences”; Pirogov Russian National Research Medical UniversityRussian FederationНИИ организации здравоохранения и медицинского менеджментаРоссияResearch Institute for Healthcare Organization and Medical ManagementRussian Federation2022310120222112935Copyright © Приходько Е.А., Беляева И.А., Кругляков А.Ю., Михеева А.А., Горев В.В., 20222022Приходько Е.А., Беляева И.А., Кругляков А.Ю., Михеева А.А., Горев В.В.Prikhodko E.A., Belyaeva I.A., Kruglyakov A.Y., Mikheeva A.A., Gorev V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/2835Обоснование

Обоснование. Грудное молоко является оптимальным питанием для поздних недоношенных детей, но матери таких детей нередко сталкиваются с трудностями при организации грудного вскармливания, связанными с началом и становлением лактации.

Цель исследования — изучить факторы, ассоциированные с успешным грудным вскармливанием поздних недоношенных детей в неонатальном стационаре.

Методы

Методы. В ретроспективное исследование включены истории болезни поздних недоношенных детей (гестационный возраст 34–36 нед), поступивших в отделение неонатологии в течение одного календарного года. Учитывали факторы со стороны матерей и новорожденных в связи с исключительно грудным вскармливанием при выписке из стационара. Исключительно грудное вскармливание определяли как отсутствие другой пищи или питья, даже воды, кроме грудного молока (сцеженного или донорского), но позволяющее младенцу получать энтерально жидкость с целью регидратации, а также капли и сиропы (витамины, минералы, лекарства). Определение независимых предикторов выполнено с использованием многофакторной бинарной логистической регрессии.

Результаты

Результаты. При выписке из стационара исключительно грудное вскармливание получали 84 (41%) ребенка, остальные новорожденные находились на искусственном или смешанном вскармливании. Многофакторный анализ показал, что с относительно высокой вероятностью с исключительно грудным вскармливанием при выписке из стационара были связаны гестационный возраст 36 нед (в сравнении с 34 нед отношение шансов (OШ) 2,16; 95% доверительный интервал (ДИ) 1,18–3,98) и начало кормления материнским молоком в первые 6 ч жизни (ОШ 2,38; 95% ДИ 1,19–4,75), с низкой вероятностью — наличие двойни (ОШ 0,31; 95% ДИ 0,15–0,65).

Заключение

Заключение. Вскармливание поздних недоношенных детей материнским молоком (в т.ч. сцеженным) в первые часы жизни положительно влияет на становление лактации и обеспечение исключительно грудным молоком этих пациентов в неонатальном стационаре. К группе риска раннего прекращения грудного вскармливания могут быть отнесены поздние недоношенные дети с гестационным возрастом менее 36 нед и дети из двоен.

 

 

Background

Background. Breast milk is the optimal nutrition for late preterm babies, but mothers of these babies frequently experience difficulties with breastfeeding associated with lactation onset and establishment.

Objective

Objective. The aim of the study is to examine factors associated with successful breastfeeding of late preterm infants in neonatal hospital.

Methods

Methods. The retrospective study included medical records of late preterm infants (gestational age of 34–36 weeks) admitted to neonatology department within one calendar year. Maternal and infant factors on exclusive breastfeeding were considered at hospital discharge. Exclusive breastfeeding was defined as absence of any other food or drink, even water, except breast milk (expressed or donor), whereas enteral fluid for rehydration, as well as drops and syrups (vitamins, minerals, medicines) were allowed. Determination of independent predictors was performed via multifactorial binary logistic regression.

Results

Results. 84 (41%) of children received exclusive breastfeeding at hospital discharge, others were on formula or mixed feeding. Multifactorial analysis has shown that gestational age of 36 weeks (compared to 34 weeks, odds ratio (OR) 2.16; 95% confidence interval (CI) 1.18–3.98) and breastfeeding onset in 6 first hours of life (OR 2.38; 95% CI 1.19–4.75) were associated with relatively high probability of exclusive breastfeeding at hospital discharge, and twins (OR 0.31; 95% DI 0.15–0.65) — with low probability.

Conclusion

Conclusion. Breastfeeding of late preterm babies with maternal milk (expressed milk included) in the first hours of life positively affects the lactation establishment and the provision of exclusively breast milk to these patients in neonatal hospital. The risk group for early cessation of breastfeeding may include late premature infants with gestational age less than 36 weeks and twins.

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The authors declare that there are no conflicts of interest present.