RSS-Feed abonnieren
DOI: 10.1055/s-2006-942116
© Georg Thieme Verlag Stuttgart · New York
Stillen beim Frühgeborenen
Breastfeeding in Premature InfantsPublikationsverlauf
2006
2006
Publikationsdatum:
27. Februar 2007 (online)
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Zusammenfassung
Frühgeborene Kinder haben im Vergleich zu Reifgeborenen deutlich geringere Nährstoffreserven. Zusätzliche Stressfaktoren, wie z. B. Infektionen oder ein Atemnotsyndrom beeinflussen ihren Nährstoffbedarf und ihren Stoffwechsel nachhaltig. Damit ist die Zufuhr einer ausreichenden Menge an Nährstoffen und Kalorien einer der Eckpfeiler der Versorgung und Pflege eines Frühgeborenen. Ab einem Gestationsalter von mehr als 34 Schwangerschaftswochen ist ein Frühgeborenes in der Lage effektiv an der Brust der Mutter zu saugen und den Trink- und Atemvorgang zu koordinieren. Aber auch bei der Ernährung von Frühgeborenen mit weniger als 34 Schwangerschaftswochen wird von den nationalen und internationalen Stillkommissionen der enterale Nahrungsaufbau mit Muttermilch empfohlen. Im vorliegenden Beitrag soll der Frage nachgegangen werden, ob es im Hinblick auf die Aspekte Wachstum bzw. Nährstoffbedarf, Infektionen und neurologische Entwicklung Nachteile bzw. Unsicherheiten bei der Verwendung von Muttermilch für die Versorgung sehr kleiner Frühgeborener gibt und welche Vorteile wissenschaftlich nachgewiesen werden konnten. Darüber hinaus werden praktische Vorgehensweisen zur Initiierung und Aufrechterhaltung der Milchbildung und dem Übergang von Sonden- auf Brusternährung erörtert.
Abstract
Preterm infants have fewer nutrient reserves at birth than term infants. Additional physiological and metabolic stress factors, such as infection or respiratory distress, can affect their nutritional needs and metabolism. Hence, the provision of appropriate nutrition for growth and development is a cornerstone of care of preterm infants. Well infants of a gestational age > 34 weeks are usually able to suck effectively and coordinate swallowing and breathing. Therefore establishment of breast feeding seems reasonable for newborns of this gestational age. For less mature infants, national and international advisory boards also recommend enteral human milk feeding early postnatally. Challenges remain, particularly in establishing evidence-based standards of breastfeeding and the use of human milk for preterm infants in the intensive-care nursery. This article highlights the aspects of growth and nutritional needs, infection prophylaxis and neurological development with regard to the use of human milk versus formula for the preterm infant. Approaches to the initiation and maintenance of milk supply and the decision about when to replace gavage by breast feeding are illustrated.
Schlüsselwörter
Stillen - Frühgeborene - Muttermilch
Key words
breast feeding - infant, premature - milk, human
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S. Herber-Jonat
Klinikum der Universität München · Perinatalzentrum Großhadern der Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital · Klinik und Poliklinik für Frauenheilkunde und Geburthilfe - Großhadern
Marchioninistraße 15
81377 München
Telefon: 00 49 / 89 / 70 95 28 07
Fax: 00 49 / 89 / 70 95 58 07
eMail: susanne.herber-jonat@med.uni-muenchen.de