Enteral Feeding with Human Milk Decreases Time to Discharge in Infants following Gastroschisis Repair

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• 作者：Brian C. Gulack ; MD¹ ; ² ; Matthew M. Laughon ; MD ; MPH³ ; Reese H. Clark ; MD⁴ ; Terrance Burgess ; MA Ed² ; Sybil Robinson² ; Abdurrauf Muhammad² ; Angela Zhang² ; Adrienne Davis² ; Robert Morton² ; Vivian H. Chu ; MD ; MHS⁵ ; Christopher J. Arnold ; MD⁵ ; Christoph P. Hornik ; MD ; MPH² ; ⁶ ; P. Brian Smith ; MD ; MHS ; MPH² ; ⁶ ; ^{brian.smith@duke.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：HR ; Hazard ratio ; NEC ; Necrotizing enterocolitis ; NICU ; Neonatal intensive care unit
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：170
• 期：Complete
• 页码：85-89
• 全文大小：276 K

文摘

To assess the effect of enteral feeding with human milk on the time from initiation of feeds to discharge after gastroschisis repair through review of a multi-institutional database.

Study design

Infants who underwent gastroschisis repair between 1997 and 2012 with data recorded in the Pediatrix Medical Group Clinical Data Warehouse were categorized into 4 groups based on the percentage of days fed human milk out of the number of days fed enterally. Cox proportional hazards regression modeling was performed to determine the adjusted effect of human milk on the time from initiation of feeds to discharge.

Results

Among 3082 infants, 659 (21%) were fed human milk on 0% of enteral feeding days, 766 (25%) were fed human milk on 1%-50% of enteral feeding days, 725 (24%) were fed human milk on 51%-99% of enteral feeding days, and 932 (30%) were fed human milk on 100% of enteral feeding days. Following adjustment, being fed human milk on 0% of enteral feeding days was associated with a significantly increased time to discharge compared with being fed human milk on 100% of enteral feeding days (hazard ratio [HR] for discharge per day, 0.46; 95% CI, 0.40-0.52). The same was found for infants fed human milk on 1%-50% of enteral feeding days (HR, 0.37; 95% CI, 0.32-0.41) and for infants fed human milk on 51%-99% of enteral feeding days (HR, 0.51; 95% CI, 0.46-0.57).

Conclusion

The use of human milk for enteral feeding of infants following repair of gastroschisis significantly reduces the time to discharge from initiation of feeds.