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Enterale Ernährung von Frühgeborenen

Enteral nutrition of the preterm newborn

  • Leitthema: Das kleine und sehr kleine Frühgeborene
  • Published:
Monatsschrift Kinderheilkunde Aims and scope Submit manuscript

Zusammenfassung

Die wesentliche Ursache für postnatalen Minderwuchs bei Frühgeborenen ist eine unzureichende Ernährung (Energie- und Proteinzufuhr). Infektionen, Inflammationsreaktionen und Medikamente spielen eine untergeordnete Rolle. Postnataler Minderwuchs ist mit geringem Gehirnwachstum, geringer Intelligenz und wahrscheinlich auch mit einem erhöhten Risiko für z. B. Typ-2-Diabetes, koronare Herzerkrankung und Bluthochdruck assoziiert. Er ist ein beeinflussbarer Risikofaktor für eine unzureichende neurokognitive Entwicklung. Ursachen für eine nicht ausreichende frühkindliche Ernährung sind Sicherheitsbedenken. Die parenterale Ernährung wird zu spät gestartet und zu langsam gesteigert; die enterale zu spät begonnen, zu oft abgesetzt und zu langsam gesteigert. Primäres Ziel muss es sein, die fetale Situation einer vollständigen parenteralen Ernährung so schnell wie möglich wiederherzustellen und dann schrittweise auf enterale Ernährung umzustellen. Diese Arbeit gibt einen Überblick über die frühzeitige enterale Ernährung von Frühgeborenen unter besonderer Berücksichtigung von Nährstoffbedarf und Überprüfung von Nahrungsverträglichkeit, Ernährungstechniken und Supplementierung.

Abstract

To a large extent postnatal growth failure is caused by inadequate postnatal nutrition. Postnatal growth failure is associated with poor brain growth, low IQ, coronary heart disease and hypertension. Growth failure is a marker of poor neurocognitive outcome. Owing to safety concerns, parenteral nutrition is started too late and advanced too slowly, and enteral nutrition is started too late, withheld too often and advanced too slowly. The immediate postnatal priority is to reestablish the fetal condition of full parenteral nutrition as fast as possible and gradually introduce enteral nutrition. In the present paper early enteral feeding of preterm infants is reviewed with especial reference to nutritional needs, markers of early feeding tolerance, feeding techniques and supplementation of feeds.

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Authors and Affiliations

  1. Klinik für Kinder- und Jugendmedizin, Diakoniekrankenhaus, Schwäbisch Hall

    W. A. Mihatsch

  2. Universitätsklinik für Kinder- und Jugendmedizin, Ulm

    F. Pohlandt

  3. Klinik für Kinder- und Jugendmedizin, Diakoniekrankenhaus, Diakoniestraße 10, 74523, Schwäbisch Hall

    W. A. Mihatsch

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  1. W. A. Mihatsch
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  2. F. Pohlandt
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Mihatsch, W.A., Pohlandt, F. Enterale Ernährung von Frühgeborenen. Monatsschr Kinderheilkd 153, 1165–1171 (2005). https://doi.org/10.1007/s00112-005-1262-7

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