Administración preventiva de lactancia materna donada en recién nacidos con riesgo de hipoglucemia

Abstract

La hipoglucemia neonatal es una condición frecuente con potenciales consecuencias neurológicas adversas. Su manejo convencional incluye la suplementación con fórmula artificial y, en casos más graves, la administración de solución intravenosa de dextrosa, lo que implica la separación madre-hijo, dificultades en el establecimiento de la lactancia materna y un aumento en los costos sanitarios. Entre los principales factores de riesgo asociados a la hipoglucemia neonatal se encuentran la prematuridad, el peso bajo o elevado para la edad gestacional y la condición de hijo de madre diabética. Se estima que hasta un 30% de los neonatos presentan factores de riesgo, de los cuales hasta un 50% desarrollará hipoglucemia. La lactancia materna donada (LMD) es el suplemento alimenticio recomendado por organismos internacionales para neonatos vulnerables y su empleo se ha implementado ampliamente en unidades neonatales a nivel mundial. Inicialmente reservada para grandes prematuros y pacientes en cuidados intensivos, su uso se ha expandido, siendo considerada por algunos autores como primera opción para neonatos que requieren suplemento e incluso como una estrategia terapéutica para la hipoglucemia neonatal...Neonatal hypoglycemia is a frequent condition with potential adverse neurological consequences. Its conventional management includes supplementation with artificial formula and, in more severe cases, administration of intravenous dextrose solution, which implies mother-infant separation, difficulties in establishing breastfeeding, and increased health care costs. Among the main risk factors associated with neonatal hypoglycemia are prematurity, low or high weight for gestational age, and being the child of a diabetic mother. It is estimated that up to 30% of neonates have risk factors, of which up to 50% will develop hypoglycemia.Human Donor Milk (HDM) is the nutritional supplement recommended by international organizations for vulnerable neonates and its use has been widely implemented in neonatal units worldwide. Initially reserved for large preterm and intensive care patients, its use has expanded, being considered by some authors as the first option for neonates requiring supplementation and even as a therapeutic strategy for neonatal hypoglycemia.Primary prevention is a key strategy to optimize health resources and improve the quality of care. In this context, a prospective intervention study is proposed to evaluate the early administration of a single dose of 10-15 ml of HDM in neonates with risk factors for hypoglycemia, with the aim of preventing its occurrence and determining the impact of this intervention on the incidence of hospital admissions for neonatal hypoglycemia and on the estimated health care cost...