Taburculuk Sonrası Prematüre Beslenmesi

ÖzTaburculuk sonrasında özellikle ileri derecede preterm yenidoğanların nasıl besleneceği ile ilgili bilgiler az sayıda ve tartışmalıdır. Sınırlı kanıtlar taburculuk sonrasında preterm yenidoğanların “preterm formülleri” ile beslenmesinin postterm 18 aya kadar büyüme hızını artırdığını ve term formüllerle ve desteklenmemiş donor sütle beslenenlerle karşılaştırıldığında nörogelişimsel sonuçları iyileştirdiğini göstermekteyse de, desteklenmiş anne sütünden daha iyi nörogelişimsel sonuçlara yol açmamaktadır. Taburculuk sonrası beslenmenin gözde seçeneklerinden biri olarak sunulan “taburculuk sonrası formülü” ile beslenme ile ilgili eldeki son kanıtlar ise bu amaçla kullanımını desteklememektedir. Bu durum anne sütünün eşsiz yapısını birkez daha kanıtlamakta ve formüllerin mümkün olduğunca anne sütüne en fazla benzeyecek şekilde üretilmesi gereğini ortaya koymaktadır. Taburculuk sonrası preterm yenidoğanın beslenmesinde hedef, anne sütünün idame ettirilmesi, besin eksikliklerinin en aza indirgenmesi, ve eksiklik saptandığında hızlıca düzeltilmesi ancak düzeltirken aşırı beslenmeye yol açılmaması olmalıdır. Bu hedeflere ulaşmada genel rehberlerden ziyade büyümeyi , büyüme kalitesini (yağsız vücut kütlesi gibi) ve bazıbesin eksikliklerini temel alan bireysel yaklaşım önerilmektedir.

Anahtar Kelimeler:

preterm yenidoğan, beslenme, taburculuk-sonrası

Nutrition of Premature Infants After Discharge

AbstractKnowledge about how to feed especially very preterm infants after hospital discharge are conflicting and scarce. Limited evidence suggests that feeding ’preterm formula’ to preterm infants after hospital discharge may increase growth rates upto 18 months post term and improve neurodevelopmental outcomes compared to termformulas and unfortified donor milk, however they do not produce neurodevelopmental outcomes better than fortified human milk. On the other hand, one of the popular alternatives of postdischarge nutrition for preterm infants, ’postdischarge formula’ feeding is not supported by available evidence. This again indicates that maternal milk has unique properties that formulas need to mimic as closely as possible. The goal in nourishing preterm infants after discharge should be to maintainmaternal milk, minimize nutrient deficits, promptly address these deficits once identified, and avoid overnourishing once nutrient deficits have been corrected. To achieve these goals, an individualized approach based on growth, quality of growth (lean body mass etc.), and selective nutrient deficiencies is recommended over theuse of general guidelines.

Keywords:

preterm infant, nutrition, post-discharge,

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ISSN: 1309-0453
Başlangıç: 2009
Yayıncı: Selen Medya Yayıncılık Tanıtım ve Organizasyon Hizmetleri

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