Breast milk, whether the ratio of nutritional ingredients or immunological characteristics, were the most suitable for physiological needs of preterm infants. However, breast milk composition was in dynamic change, causing imbalance of energy, which could not make the premature infant to achieve the desired growth state. Human milk fortifier, retaining advantages of the breast milk, promoted growth of premature infants further. This review primarily focused on two ways of adding human milk fortifiers, standardization fortification and targeted fortification. The former was widely used in neonatal intensive care unit, while the latter was more able to explore the growth of premature infant potentially, and to achieve a more ideal ectopic growth rate. With the development of breast milk bank, storage and component extraction technology brought about donor human milk-based human milk fortifier, which provided new directions of very low birth weight infants and very preterm infants breastfeeding. The progress of human milk fortification of premature infants was closely related to expansion of multi-disciplinary centers, and only the harmonious development of multi-center maked things much more rational and systematic.

Objective To investigate the level of uncertainty in illness, anxiety and depression for mothers with premature infants in neonatal intensive care unit(NICU), and to analyze the correlation between them. Methods Totally 100 mothers with premature infants hospitalized in NICU were into the experiment group. They were investigated with the General Information Questionnaire, the Parent,s Perception Uncertainty Scale-Family (PPUS-FM), Self-Rating Anxiety Scale(SAS), and Self-Rating Depression Scale(SDS). Results The total score of uncertainty in illness was (82.840±29.132) points;the total score of anxiety was (43.360±13.033) points;the total score of depression was (60.740±16.847) points. The total score of uncertainty in illness, unclear, complexity, lack of information and unpredictability were positively correlated with the total score of anxiety and depression (r=0.186-0.399, P<0.05 or 0.01). Conclusions Mothers with premature infants hospitalized in NICU show a high level of uncertainty in illness, anxiety and depression, and they are interacted with each other. Therefore, in addition to nursing preterm infants, nursing staff should attach importance to their mothers′ psychological needs, help them reduce the uncertainty in illness so as to relieve the anxiety, depression and promote their health in body and mind.

Objective To study the effect of comprehensive pain intervention on newborns' acute pain stimulus on heel's blood collection.Methods One hundred neonates were equally randomized into control group and treatment group.In the former,blood collection was done from heel without any intervention and in the latter the comprehensive intervention was done five minutes before blood collection from heel and 5 minutes after that.The two groups were compared in terms of heart rate,blood oxygen saturation,acute pain stimulus,crying time during collection and time for facial expressions 30 seconds before collection and 30 seconds after that.Results The score on pains and crying time during collection and time of pain face in the intervention group were significantly lower or shorter than those in the control group and the time for crying and painful facial expressions was both significantly shorter than those in the control group (P＜0.001).There was insignificant different in blood oxygen saturation (P＞0.05) and significant in the heart rate (P＜.0.01) 30 seconds before and after collection.Conclusion The comprehensive intervention by radiation warming,nipple or 10％ glucose sucking,caressing and curled-up position can relieve effectively the pains from neonatal invasive operation.

Objective To evaluate the feeding effect of semi-demand feeding and abdominal massage on the feeding process, feeding performances and clinical safety (including the time of returning to birth weight, feeding tolerance, apnea). Methods A total of 120 preterm infants that met inclusion criteria of the study were randomly assigned to three groups, and each group had 40 cases. Control group:received standard feeding care. Semi-demand feeding group: received 5-10 minutes of oral motor intervention every time before feeding(including oral stimulation and non nutritional sucking), then decided feeding methods according to its consciousness behavior state. Semi-demand feeding combined abdominal massage group: received both semi-demand feeding and abdominal massage before feeding. Observed and recorded the three groups′ transition time, whether there were statistically significant differences in feeding performance and clinical safety. Results The feeding transition time was (11.55± 4.69), (10.98±3.85), (8.50±3.87)d in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences (F=6.088, P=0.003). In terms of feeding performance, the feeding efficiency were (7.27 ± 2.65), (9.74 ± 2.63), (9.52 ± 2.13) ml/min, the feeding proficiency were (66.31 ± 14.51)%, (76.64 ± 12.46)%, (82.26 ± 10.65)%, the volume transfer were (63.99 ± 11.02)%, (80.16 ± 14.41)%, (84.97 ± 11.16)% in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences (F=12.189, 16.383, 31.959, all P < 0.01).Among the clinical safety, the time of restoration of birth weight were (10.55 ± 1.99), (9.28 ± 1.77), (10.05 ± 2.46) d in control group, semi-demand feeding group and semi-demand feeding combined abdominal massage group, and there were significant differences(F=3.759, P=0.026). The incidence of feeding intolerance were 50.0%(20/40), 40.0%(16/40), 22.5%(9/40), and there were significant differences(χ2=6.613, P=0.037). The incidence of apnea were 37.5%(15/40), 20.0%(8/40), 15.0%(6/40), and there were significant differences(χ2=6.093, P=0.048). Conclusions The combined intervention methods could accelerate the feeding process, improve feeding performance as well as reduce the incidence of feeding intolerance and apnea. Hence, semi-demand feeding combined abdominal massage is a recommended choice for clinical use.