Effects Of Three Different Milk Feedings On Feeding Tolerance For Preterm Infants

BackgroundIn recent years,with the improvement of reproductive medicine and neonatal diseases treatment level,the birth rate and survival rate of preterm infants are gradually increased.Due to immature various organs and low resistance,preterm infants are prone to respiratory distress syndrome,infection,hyperbilirubinemia and other complications.After birth,feeding had a significant effect on the survival,growth and long-term prognosis of preterm infants.Because gastrointestinal development is immature,pepsin and enterokinase activity is low,the ability to hydrolyze protein is poor,preterm infants are prone to feeding intolerance after intestinal feeding,manifested as vomiting,bloating,blood stool,gastric retention,gastroesophageal reflux and so on,serious can appear neonatal necrotic enterocolitis(NEC).Besides above symptoms,NEC can also occur intestinal perforation,intestinal necrosis,shock and other life-threatening.Feeding intolerance or NEC can affect the growth of body quality,cause extrauterine growth retardation,decrease the quality of life and survival rate.Reasonable feeding can reduce the incidence of feeding intolerance,promote its body weight growth,improve its neurodevelopmental outcome.Enteral feeding of preterm infants content of breast milk,formula milk and so on.Nutrition of breast milk is very rich,containing a variety of nutrients,immune factors,hormones and other biological ingredients.Breast milk was the best baby food,should be the first choice for preterm infants.But in some cases because of various reasons,preterm infants may not be able to achieve breast feeding,need to choose a kind of formula milk.Now the kinds of formula milk are various,including liquid formula,premature ordinary milk powder,deep hydrolyzed protein formula and so on,but which kind of milk powder can reduce the incidence of feeding intolerance,more suitable feeding for preterm infants,there is no definite conclusion.ObjectiveTo compare the recovery time of birth weight,feeding intolerance,neonatal necrotizing enterocolitis of preterm infants fed by liquid formula,premature ordinary milk powder or deep hydrolyzed protein formula,and to provide the basis for the choice of enteral nutrition in preterm infants.Subjects and Methods1 Subject and groups280 cases of preterm infants from Nov 2015-Jul 2016 were as a study object,which had not started any form of enteral feeding before entering the wards,gestational age less than 37 weeks,excluding such infants with congenital gastrointestinal malformations,congenital genetic metabolic diseases and congenital heart disease in children.According to the random number table,they were divided into three groups: the premature liquid formula milk group(100 cases in group A),the premature ordinary milk powder group(100 cases in group B),and the deep hydrolyzed protein formula group(80 cases in group C).Recording the sex,gestational age,birth date,birth weight,asphyxia,umbilical vein catheterization and so on.To observe and compare the recovery time of birth weight,the incidence of feeding intolerance and NEC among three groups of preterm infants.This study was carried out with the approval of the hospital medical ethics committee and the informed consent of the family.2 Statistical analysisSPSS21.0 software were used for statistical analysis.The data were expressed by the mean ± standard deviation(x_±s),compared with t test.Count data were expressed by the rate(%),compared with chi-square test.The level of statistical significance was set at P<0.05.Results1 To compare the recovery time of birth weight among three groups of preterm infantsBirth weight recovery time of group A was(6.18 ± 2.97)days,birth weight recovery time of group B was(4.99 ± 2.45)days,birth weight recovery time of group C was(6.13 ± 2.91)days.Birth weight recovery time of group B was the shortest,the difference was statistically significant(P <0.05),while birth weight recovery time of group A and group C were similar,the difference was not statistically significant(P> 0.05).2 To compare the feeding intolerance among three groups of preterm infantsThere were 31 cases(31%)with feeding intolerance in group A,18 cases(18%)in group B and 12 cases(15%)in group C.Feeding intolerance of group B and group C were better than group A,the difference was statistically significant(P <0.05),while there was no significant difference in feeding tolerance between group B and group C(P> 0.05).3 To compare the occurrence of NEC among three groups of preterm infantsThere were 3 cases of NEC in group A,2 cases of NEC in group B and no occurrence of NEC in group C,the difference was not statistically significant(P> 0.05).Conclusions1.Premature liquid formula milk is more prone to feeding intolerance than premature ordinary milk powder,deep hydrolyzed protein formula.2.Premature ordinary milk powder in the recovery time of birth weight is better than premature liquid formula milk,deep hydrolyzed protein formula.3.The incidence of NEC in preterm infants has nothing to do with the type of milk powder.