极低出生体重儿尽早达到足量肠内营养喂养策略——《极低出生体重儿喂养指南》解读

Feeding strategy of the very low birth weight infants to achieve adequate enteral nutrition as soon as possible:Interpretation of Guidelines for Feeding Very Low Birth Weight Infants

极低出生体重儿的营养和喂养不仅对减少初生早期的合并症而且对远期预后产生重要影响。营养和喂养的目标是在保证安全的前提下,尽早建立肠内喂养,尽快地达到全肠内营养。2015年加拿大麦克马斯特大学儿童医院发表了《极低出生体重儿喂养指南》,内容涉及到临床上极低出生体重儿的营养和喂养经常遇到的问题,包括极低出生体重儿达到足量肠内营养的时间、开奶时间和喂养频次、出生早期肠内营养喂养方式的选择、奶量增加的速度、喂养耐受性的评估、胃内残余奶量的管理,以及早产儿胃食管反流等。

Giving good nutrition and feeding for very low birth weight infant （ELBWI） can help to reduce complication during the early stage as well as improve the long-term prognosis. The goal of giving good nutrition and feeding is to establish enteral feeding as soon as possible to achieve full enteral nutrition on the premise of safety. Guidelines for Feeding Very Low Birth Weight Infants published by McMaster University Children＇ s Hospital in 2015 is analyzed. Those issues include the time to reach full nutrition, frequency of feeding, time of starting feeding, way of feeding, increasing of the amount of milk, assessment of feeding tolerance, management of residuals and clinical diagnosis of gastro-esophageal reflux （GER）.