Lactancia materna en las unidades neonatales españolas. Práctica clínica y factores asociados
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2017
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02/02/2016
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Universidad Complutense de Madrid
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"Introducción" La leche humana es la primera opción para alimentar al prematuro y al recién nacido enfermo porque el uso de sucedáneos de leche de madre se asocia con un incremento de resultados adversos a corto y a largo plazo. A pesar de ello, la tasa de lactancia materna en los recién nacidos prematuros es menor que en los recién nacidos a término por lo que la población más vulnerables se expone a mayores riesgos. Son necesarias por tanto, políticas de apoyo a la lactancia materna en las unidades neonatales que reviertan esta situación. Aunque la Iniciativa para la Humanización de la Asistencia al Nacimiento y la Lactancia (IHAN) ha sido adaptada a las Unidades Neonatales (Neo-IHAN), actualmente no existe una política unificada sobre cómo promocionar la lactancia materna en la Unidad Neonatal. Por otro lado, las necesidades nutricionales de los grandes prematuros (peso al nacimiento menor de 1500g o menores de 32 semanas de edad gestacional) son muy elevadas. Para cubrirlas, se precisa de un manejo exquisito de la leche materna y está recomendada su fortificación en este grupo de pacientes. Sin embargo, tampoco existe una política unificada sobre las prácticas de nutrición enteral con leche materna en los grandes prematuros. Para mejorar las medidas de apoyo a la lactancia y las prácticas de alimentación enteral con leche materna, es necesaria la participación de todos los grupos de profesionales incluidos en la Unidad neonatal. Conocer las percepciones de todos ellos ayudaría a implantar políticas unificadas en las que el trabajo multidisciplinar es esencial...
"Introduction"Human milk is the first option for feeding premature and sick new-borns because breast-milk substitutes are associated with an increase in adverse outcomes in both the short and long term. Despite this, the rate of breastfeeding in preterm infants is lower than in term infants so the most vulnerable population is exposed to higher risks. Therefore, policies that support breastfeeding in neonatal units are needed to reverse this situation. Although the Baby-Friendly Hospital Initiative (BFHI) has been adapted to the Neonatal Units (Neo-BFHI), currently there is no unified policy on how to promote breastfeeding in the neonatal unit. On the other hand, the nutritional requirements of very premature infants (birth weight less than 1500g or less than 32 weeks gestational age) are very high. To cover them, it requires a precise management of breast milk and human milk fortification is recommended for this group of patients. However, there is not a unified policy on enteral nutrition practices with breast milk in very premature infants. To improve breastfeeding support measures and enteral nutrition practices with breast milk, the participation of all groups of professionals included in the neonatal unit is necessary. Knowing their perceptions would help to implement unified policies where multidisciplinary work is essential...
"Introduction"Human milk is the first option for feeding premature and sick new-borns because breast-milk substitutes are associated with an increase in adverse outcomes in both the short and long term. Despite this, the rate of breastfeeding in preterm infants is lower than in term infants so the most vulnerable population is exposed to higher risks. Therefore, policies that support breastfeeding in neonatal units are needed to reverse this situation. Although the Baby-Friendly Hospital Initiative (BFHI) has been adapted to the Neonatal Units (Neo-BFHI), currently there is no unified policy on how to promote breastfeeding in the neonatal unit. On the other hand, the nutritional requirements of very premature infants (birth weight less than 1500g or less than 32 weeks gestational age) are very high. To cover them, it requires a precise management of breast milk and human milk fortification is recommended for this group of patients. However, there is not a unified policy on enteral nutrition practices with breast milk in very premature infants. To improve breastfeeding support measures and enteral nutrition practices with breast milk, the participation of all groups of professionals included in the neonatal unit is necessary. Knowing their perceptions would help to implement unified policies where multidisciplinary work is essential...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Pediatría, leída el 02-02-2016