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Педиатрическая фармакология

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Организация грудного вскармливания в отделениях реанимации и интенсивной терапии недоношенных детей: дискуссионные вопросы

https://doi.org/10.15690/pf.v16i3.2027

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Аннотация

Приоритетность обеспечения грудного вскармливания при выхаживании недоношенных младенцев не подвергается сомнению. Для детей, родившихся преждевременно, вскармливание грудным молоком обеспечивает двойной эффект, снижая риск как ближайших, так и отдаленных последствий, связанных с недоношенностью. В этой связи на международном уровне предпринимаются чрезвычайные шаги по поощрению и поддержке вскармливания новорожденных грудным молоком, в том числе в отделениях интенсивной терапии. Собственное молоко матери является первым выбором для кормления недоношенного ребенка. В последние годы обсуждаются проблемы качества и безопасности сцеженного грудного молока — как пастеризованного, так и свежего — для новорожденных пациентов отделений реанимаций и интенсивной терапии. Авторы указывают, что процедуры обработки и условия хранения сцеженного грудного молока существенно различаются, отсутствуют единые критерии его микробиологической безопасности. Все это ограничивает использование сцеженного грудного молока, прежде всего у недоношенных новорожденных. Помимо опасности бактериального инфицирования, в отношении недоношенных младенцев обсуждается риск заражения цитомегаловирусом (ЦМВ) при использовании свежего молока ЦМВ-серопозитивной матери. В обзоре рассматриваются критерии риска инфицирования детей ЦМВ и показания к избирательной обработке грудного молока для инактивации вероятного патогена.

Об авторах

И. А. Беляева
Морозовская детская городская клиническая больница; Российский национальный исследовательский медицинский университет имени Н.И. Пирогова
Россия

Беляева Ирина Анатольевна - доктор медицинских наук, профессор РАН, руководитель неонатологической службы ГБУЗ «Морозовская ДГКБ ДЗМ»; профессор кафедры факультетской педиатрии ФГБОУ ВО «РНИМУ им. Н.И. Пирогова».

119049, Москва, 4-й Добрынинский пер., д. 1/9, тел.: +7 (499) 236-31-21



Л. С. Намазова-Баранова
Российский национальный исследовательский медицинский университет имени Н.И. Пирогова; Центральная клиническая больница Российской академии наук; Белгородский государственный национальный исследовательский университет
Россия

Москва



Н. Н. Володин
Национальный медицинский исследовательский центр детской гематологии, онкологии и иммунологии имени Дмитрия Рогачёва
Россия

Москва



Е. Е. Петряйкина
Морозовская детская городская клиническая больница; Российский национальный исследовательский медицинский университет имени Н.И. Пирогова
Россия

Москва



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Для цитирования:


Беляева И.А., Намазова-Баранова Л.С., Володин Н.Н., Петряйкина Е.Е. Организация грудного вскармливания в отделениях реанимации и интенсивной терапии недоношенных детей: дискуссионные вопросы. Педиатрическая фармакология. 2019;16(3):152-158. https://doi.org/10.15690/pf.v16i3.2027

For citation:


Belyaeva I.A., Namazova-Baranova L.S., Volodin N.N., Petryaykina E.E. Organization of breastfeeding in neonatal intensive care units: discussion issues. Pediatric pharmacology. 2019;16(3):152-158. (In Russ.) https://doi.org/10.15690/pf.v16i3.2027

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