捐赠母乳的临床应用及人乳库发展

The clinical application of donated human milk and the establishment of human milk banks

生命早期1000 d是婴幼儿体格发育和智力发育的关键阶段,是预防成年期慢性疾病的窗口期。这一阶段的营养支持对婴幼儿生长发育和终身健康至关重要。母乳具有独特的营养和免疫活性,是此阶段最理想的食物来源。母乳喂养对儿童健康的短期及长期益处已被广泛报道。对于无法获得足够亲母母乳的新生儿,捐赠母乳是提供营养的首选和最佳选择,捐赠母乳对降低新生儿疾病的发病率、死亡率和新生儿监护病房医疗费用有一定作用。处理捐赠母乳的专业机构是人乳库,随着全球人乳库的发展,我国人乳库的建设也在飞速发展。截至2021年,我国已发布关于医疗机构人乳库运营和管理的相关官方标准,也有关于人乳库单位成本或成本分析的相关数据。人乳库的建设对捐赠母乳的临床应用起到了保障、规范和促进作用。目前,我国人乳库建设亟须解决的问题是运营资金不足和捐赠者及捐乳乳量不稳定。为给捐赠母乳和人乳库的发展提供更多的循证医学基础,仍需在捐赠母乳的应用价值、捐赠母乳灭菌方式及资金来源拓展、人乳库运营及成本优化等多方面进一步探索研究。

The first 1000 days of life is a crucial stage for the physical and intellectual development of infants and a critical window for preventing chronic diseases in adulthood.The nutrition support during this period is of vital importance for the growth and lifelong health of infants.Breast milk has unique nutritional and immune activity and is the most ideal food source for infants during this period.Short-and long-term health benefits associated with breast-feeding have been widely reported.Donated human milk represents the first and best choice for providing nutrients to newborns who cannot obtain sufficient human milk from their biological mothers.Donated human milk can decrease the morbidity and mortality of neonatal diseases,thus reducing the medical costs of the neonatal intensive care.Human milk banks are professional public institutions that deals with donated human milk.With the development of human milk banks worldwide,the construction of China's human milk banks has also seen rapid progress.China has already issued the official policies and standards for the operation and management of human milk banks by 2021.There are also published data available regarding the unit costs and cost analyses of operating human milk banks.Human milk banks have played an important role in ensuring,regulating,and promoting the clinical application of donated human milk.Inadequate resource of financial funding,the instability of donors and insufficient donated human milk are the major challenges domestic human milk banks are facing with and requiring urgent resolutions.It is imperative to further dive into the value of donated human milk,optimize the operation of the human milk banks,develop new methods and means of milk sterilization and expand the funding sources,for the purpose of providing more evidence to steer the development of donated human milk and human milk banks.