日本新生児成育医学会雑誌　第30巻　第2号　77～83頁（2018年）

日本新生児成育医学会雑誌　30(2)：325-331；2018　

受付日：平成29．12．18

受理日：平成30．02．28

早産児，低出生体重児への母乳投与：第2 報　新生児集中治療室退院後1 か月における検討

Breastfeeding 1 Month after Discharge from the Neonatal Intensive Care Unit in Preterm and/or Low-Birth-Weight Infants

群馬県立小児医療センター　新生児科

Department of Neonatology, Gunma Children’s Medical Center

丸山憲一・小泉亜矢・井上文孝・福田一代・市之宮健二・宮川陽一

Kenichi MARUYAMA，Aya KOIZUMI，Fumitaka INOUE，Kazuyo FUKUDA， Kenji ICHINOMIYA，Youichi MIYAKAWA

Key Words：breastfeeding，preterm infant，low-birth-weight infant，neonatal intensive care unit

　2013 年3 月～ 2015 年2 月に当科に生後24 時間未満で入院した在胎36 週未満もしくは出生体重2,300g 未満の児で，重症の先天異常の児などを除いた137 例の新生児集中治療室退院後の母乳投与について後方視的検討を行った。退院後1 か月で混合栄養を含めた母乳投与の児は114 例（83.2％）で，母親の学歴，退院時母乳投与のあった児の割合が人工栄養の児と比べ有意に高く，多変量解析では退院時の母乳投与が退院後1 か月での母乳投与に有意に関連していた。退院後1 か月で母乳のみの児は29 例（21.2％）で，それ以外の児と比べ経膣分娩，退院時母乳のみ投与の児の割合，退院後1 か月間の体重増加率が有意に高く，出生体重当たり授乳量100mL/kg/ 日到達日齢，退院日齢が有意に早かった。多変量解析では退院日齢が早いことと退院時母乳のみの投与が退院後1 か月での母乳のみの投与と有意に関連していた。これらの因子を考慮して母乳育児支援を行うことが望まれる。

　To clarify the breastfeeding rates and the factors associated with breastfeeding in preterm and/or low-birth-weight infants 1 month after discharge from the neonatal intensive care unit（ NICU）, we conducted a retrospective study of 137 infants at a gestational age of ＜36 weeks and/or birth weight ＜2,300g who were admitted to our NICU ＜24 hours after birth between March 2013 and February 2015. Of the 137 infants, 23（ 16.8%） were exclusively fed formula and 29（ 21.2%） were exclusively breastfed 1 month after discharge. Compared with formula-fed infants 1 month after discharge, in those given breast milk, the maternal education level and the rate of infants given breast milk at the time of discharge from the NICU were significantly higher. Multivariate analyses revealed that breastfeeding at the time of discharge from the NICU was the sole factor significantly associated with breastfeeding 1 month after discharge. Comparison of infants breastfed exclusively 1 month after discharge and all others revealed significant differences in terms of rates of infants born by vaginal delivery and rates of exclusive breastfeeding at discharge, body weight gain 1 month after discharge, age at which feeding volume per birth weight reached 100mL/kg/day, and age at discharge. Multivariate analyses revealed that exclusive breastfeeding at discharge and early age at the time of discharge are significantly associated with exclusive breastfeeding 1 month after discharge. Considering these factors, breastfeeding should be supported in preterm and/or low-birth-weight infants.