The importance of breast milk in the nutrition of premature infants

Abstract

Nedonoščad, odnosno djeca rođena prije 37. tjedna gestacije suočavaju se s brojnim izazovima zbog nezrelosti svojih organa i imunološkog sustava, a njihova prehrana igra ključnu ulogu u osiguravanju optimalnog rasta i razvoja. Majčino mlijeko je najbolji izvor hranjivih tvari za nedonoščad jer sadrži jedinstvene sastojke poput oligosaharida, koji podržavaju razvoj crijevne mikrobiote i imunološkog sustava. Osim toga, majčino mlijeko se prilagođava potrebama djeteta, pružajući optimalnu kombinaciju proteina, masti, ugljikohidrata, vitamina i minerala. Međutim, neke majke nedonoščadi mogu imati poteškoće s dojenjem zbog zdravstvenih problema ili nedovoljne proizvodnje mlijeka. U takvim slučajevima, alternativa može biti humano mlijeko iz banke mlijeka. Banke mlijeka prikupljaju, testiraju, pasteriziraju i distribuiraju donirano majčino mlijeko kako bi osigurale sigurnu prehranu za djecu kojoj je ono najpotrebnije. Ovaj sustav omogućuje nedonoščadi pristup hranjivim tvarima koje su ključne za njihov razvoj, čak i ako njihova majka ne može dojiti. U Hrvatskoj je 2019. godine otvorena banka humanog mlijeka koja danas djeluje unutar Kliničkog zavoda za transfuzijsku medicinu i transplantacijsku biologiju Kliničkog bolničkog centra Zagreb. Osnovana je s ciljem osiguravanja sigurnog i kvalitetnog majčinog mlijeka za najranjiviju skupinu novorođenčadi. U svrhu izrade završnog rada provedeno je istraživanje koje ima za cilj ispitati mišljenja javnosti o značaju majčinog mlijeka u prehrani prijevremeno rođene djece, razinu informiranosti o bankama humanog mlijeka te način na koji se percipira uloga medicinskih sestara u pružanju podrške majkama. Istraživanje je obuhvatilo 583 sudionica. 503 (86,3%) sudionika smatra majčino mlijeko najboljim izborom za prehranu prijevremeno rođene djece, dok 57 (9,8%) vjeruje da su mliječne formule jednako dobre. 457 (78,5%) ispitanih prepoznaje ulogu majčinog mlijeka u smanjenju rizika od nekrotizirajućeg enterokolitisa, dok njih 125 (21,5%) nije upoznato s tom činjenicom. 484 (83,1%) ispitanih smatra da majčino mlijeko poboljšava probavu i jača imunitet, dok 98 (16,9%) nije sigurno. 374 (64,2%) ispitanih ne zna dovoljno o funkciji banki humanog mlijeka, dok 208 (35,8%) smatra da je informirano o doniranju i korištenju mlijeka. 423 (72,6%) sudionika vjeruje da medicinske sestre imaju ključnu ulogu u edukaciji i podršci majkama pri dojenju.Preterm infants, or children born before the 37th week of gestation, face numerous challenges due to the immaturity of their organs and immune system, and their nutrition plays a crucial role in ensuring optimal growth and development. Breast milk is the best source of nutrients for preterm infants as it contains unique components such as oligosaccharides, which support the development of gut microbiota and the immune system. Additionally, breast milk adapts to the baby’s needs, providing an optimal combination of proteins, fats, carbohydrates, vitamins, and minerals. However, some mothers of preterm infants may experience difficulties with breastfeeding due to health issues or insufficient milk production. In such cases, an alternative can be human milk from a milk bank. Milk banks collect, test, pasteurize, and distribute donated breast milk to ensure safe nutrition for children who need it the most. This system allows preterm infants access to essential nutrients crucial for their development, even if their mother is unable to breastfeed. In Croatia, a human milk bank was established in 2019 and today operates within the Clinical Institute for Transfusion Medicine and Transplant Biology at the Clinical Hospital Center Zagreb. It was founded with the aim of ensuring safe and high-quality breast milk for the most vulnerable group of newborns. For the purpose of completing a final thesis, a study was conducted to examine public opinions on the importance of breast milk in the nutrition of preterm infants, the level of awareness regarding human milk banks, and the perception of the role of nurses in supporting mothers. The study included 583 participants. 503 (86.3%) of respondents consider breast milk the best choice for feeding preterm infants, while 57 (9.8%) believe that infant formulas are equally suitable. 457 (78.5%) of respondents recognize the role of breast milk in reducing the risk of necrotizing enterocolitis, while 125 (21.5%) are not aware of this fact. 484 (83.1%) of respondents believe that breast milk improves digestion and strengthens immunity, whereas 98 (16.9%) are uncertain. 374 (64.2%) of respondents do not know enough about the function of human milk banks, while 208 (35.8%) believe they are informed about donation and usage. 423 (72.6%) of respondents believe that nurses play a key role in educating and supporting mothers in breastfeeding