CN118506984B - Personalized management system for breast milk fortifier of premature infant - Google Patents

Abstract

The invention discloses a personalized management system of a breast milk enhancer for premature infants, which comprises an information acquisition module, a breast milk content analysis module, a blood urea nitrogen measurement module and a strategy generation module; wherein: an information acquisition module: obtaining the birth day, weight, and daily breast feeding amount of the target premature infant; obtaining different breast milk fortifier brands of protein and energy; breast milk content analysis module: measuring protein and breast milk energy in breast milk of a target puerpera; blood urea nitrogen measurement module: monitoring the blood urea nitrogen level of the target premature infant; the strategy generation module: strategies were generated to modulate the breast milk fortifier. The invention provides a personalized management system for a breast milk fortifier of a premature infant, which can help a nursing team to record and track the nutrition intake, the growth data and the health result of the premature infant by using electronic health records and other information technology tools, so that the use of the breast milk fortifier is managed more effectively.

Description

An individualized management system for breast milk fortifiers for premature infants

Technical Field

The present application relates to the technical field of data management, and in particular to an individualized management system for premature infant breast milk fortifiers.

Background Art

Premature birth, asphyxia and infectious diseases are the three main causes of neonatal death. Premature infants have low immunity and incomplete development of various systems. They are prone to various complications during hospitalization, and nutritional support plays an important role in the successful treatment of premature infants. The American Academy of Pediatrics recommends the use of human milk fortifier (HMF) for premature infants who are breastfed to ensure that the expected nutritional needs of premature infants are met. Breast milk fortifier is a nutritional fortifier that contains multiple nutrients such as protein, carbohydrates, minerals (calcium, phosphorus, iron, zinc, manganese, magnesium, copper), trace elements, vitamins and electrolytes. Because the content of some nutrients in breast milk cannot meet the growth needs of premature infants, it is necessary to add breast milk fortifiers while breastfeeding, so that premature infants can obtain the benefits of breastfeeding and meet their nutritional needs for rapid growth and development. The application of breast milk fortifiers in China has been relatively short, and most of the current clinical studies are about the necessity and safety of using breast milk fortifiers for premature infants. There are relatively few studies on individualized fortification programs and the use of breast milk fortifiers. How to safely adjust the dosage of human milk fortifier according to the protein content in breast milk and the physiological maturity and growth of premature infants is an important issue in the field of neonatal nutrition.

Summary of the invention

To solve the above problems, the technical solution of the present invention is:

A premature infant breast milk fortifier individualized management system, comprising an information acquisition module, a breast milk content analysis module, a blood urea nitrogen measurement module, and a strategy generation module; wherein:

Information acquisition module: obtaining the birth day, weight and breast milk feeding amount of the target premature infant on the same day; obtaining the protein and energy of different brands of breast milk fortifiers (preferably, the protein and energy of different brands of breast milk fortifiers are obtained by consulting the instructions or measured by a breast milk analyzer);

Breast milk content analysis module: measures the protein and breast milk energy in the target mother’s breast milk;

Blood urea nitrogen measurement module: after the target premature infant uses the breast milk fortifier, the blood urea nitrogen measurement module monitors the blood urea nitrogen level of the target premature infant;

Strategy generation module: Based on the birth days and weight of the target premature infants, the amount of breast milk, breast milk protein, breast milk energy, protein and energy of different brands of breast milk fortifiers, and the protein/energy ratio consumed by premature infants, the number of bags of breast milk fortifier D1 calculated based on breast milk analysis is generated; based on the grams of breast milk fortifier per bag, the number of days the breast milk fortifier is used, and the blood urea nitrogen level, a strategy for adjusting breast milk fortifiers is generated.

Furthermore, the number of bags of breast milk fortifier to be added based on the birth days and weight of the target premature infant, the amount of breast milk, breast milk protein, breast milk energy, protein and energy of different breast milk fortifier brands, and the protein/energy ratio of the premature infant includes:

Different brands of human milk fortifiers are numbered and can be freely selected or entered;

Further, outputting the number of bags of human milk fortifier D1 calculated based on human milk analysis includes:

D _min = (P _min * b * 0.01 * M + P _min * h - a * 0.01 * M - g) / (d - P _min * e *0.2389)

D _max = (P _max * b * 0.01 * M + P _max * h - a * 0.01 * M - g) / (d - P _max * e *0.2389)

D _min < D1 < D _max

D _max is the maximum number of bags of breast milk fortifier required, D _min is the minimum number of bags of breast milk fortifier required, D1 is the number of bags of breast milk fortifier calculated based on breast milk analysis, M is the amount of breast milk (mL), W is the weight of the premature infant in question (kg), a is breast milk protein (g/dL), b is breast milk energy (kcal/dL), d is the protein of different brands of breast milk fortifiers (g/bag), e is the energy of different brands of breast milk fortifiers (kj/bag), g is other proteins ingested by premature infants (g), h is other energy ingested by premature infants (kcal), and the default values of g and h are generally 0. Among them, the values of d, e, and f vary according to the brand of breast milk fortifier, as shown in Table 1:

Table 1: Parameter input for different brands of human milk fortifiers

In a preferred embodiment, the brand of human milk fortifier is selected by the family of the target premature infant.

Furthermore, the obtaining of the number of days of use of human milk fortifier and the blood urea nitrogen level of the target premature infant includes: the number of days of use of human milk fortifier and the detection of the blood urea nitrogen level at least twice a week.

Furthermore, the strategy for adjusting the human milk fortifier based on the number of days the human milk fortifier is used and the blood urea nitrogen level includes: adjusting the amount of human milk fortifier added based on the grams of human milk fortifier per bag, the number of days the human milk fortifier is used and the detection of blood urea nitrogen levels twice a week, and determining whether additional protein needs to be added to the breast milk of premature infants.

Further strategies for adjusting the output of human milk fortifiers include:

When BUN is between 10 mg/dL and 16 mg/dL, continue standard fortification (level 0);

When BUN is less than 10 mg/dL, the fortification level is increased by 1 level, that is, level 1 is the addition of 5 g of breast milk fortifier and 0.4 g of additional protein to 100 mL of breast milk;

If BUN is still <10 mg/dL, increase by one level, level 2 is to add 5 g of breast milk fortifier and 0.8 g of additional protein to 100 mL of breast milk, and level 3 is to add 5 g of breast milk fortifier and 1.2 g of additional protein to 100 mL of breast milk;

If BUN is >16 mg/dL, the fortification level is reduced by 1 level, that is, level -1 means adding 3.75 g of breast milk fortifier to 100 mL of breast milk. If BUN is still >16 mg/dL, it is reduced by another level, that is, level -2 means adding 2.5 g of breast milk fortifier to 100 mL of breast milk.

Beneficial effects of the present invention

The present invention provides an individualized management system for breast milk fortifiers for premature infants. The use of electronic health records and other information technology tools can help the nursing team record and track the nutritional intake, growth data and health outcomes of premature infants, thereby more effectively managing the use of breast milk fortifiers. The individualized management system for breast milk fortifiers for premature infants can not only improve the pertinence and effectiveness of nutritional support, but also reflect the trend of refined and humanized nutritional support. The present invention is easy to operate, takes a short time, and can be used for application and promotion in general communities and primary health institutions.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG1 is a structural block diagram of an individualized management system for premature infant breast milk fortifiers according to the present invention.

FIG2 is a flowchart of an individualized management system for breast milk fortifier for premature infants according to the present invention.

FIG3 is a detailed schematic diagram of a system for managing an individualized management system for breast milk fortifiers for premature infants according to the present invention.

DETAILED DESCRIPTION

The embodiment of the present application provides an individualized management system for breast milk fortifier for premature infants, which can be an electronic device, which can be a server or a terminal device, wherein the server can be an independent physical server, or a server cluster or distributed system composed of multiple physical servers, or a cloud server providing cloud computing services. The terminal device can be a smart phone, a tablet computer, a desktop computer, etc., but is not limited thereto.

In conjunction with FIG1 , a premature infant breast milk fortifier individualized management system includes an information acquisition module, a breast milk content analysis module, a blood urea nitrogen measurement module, and a strategy generation module; wherein:

Information acquisition module: obtaining the birth day, weight and breast milk feeding amount of the target premature infant on the same day; obtaining the protein and energy of different brands of breast milk fortifiers;

Breast milk content analysis module: measures the protein and breast milk energy in the target mother’s breast milk;

Blood urea nitrogen measurement module: after the target premature infant uses the breast milk fortifier, the blood urea nitrogen measurement module monitors the blood urea nitrogen level of the target premature infant;

Strategy generation module: Generates the number of bags of human milk fortifier to be added based on the birth days and weight of the target premature infants, the amount of breast milk, breast milk protein, breast milk energy, protein and energy of different brands of breast milk fortifiers, and the protein/energy ratio consumed by premature infants; generates a strategy for adjusting human milk fortifiers based on the grams of breast milk fortifier per bag, the number of days the breast milk fortifier is used, and the blood urea nitrogen level.

The present invention provides an individualized management system for premature infant breast milk fortifiers as shown in Figures 2-3.

As shown in FIG2 , a personalized management system for breast milk fortifiers for premature infants is provided, which obtains birth information and current information of a target premature infant; determines the birth days and weight of the target premature infant based on the birth information and the current information; obtains breast milk information of a target pregnant woman; determines the protein and breast milk energy in the breast milk of the target pregnant woman based on instrument measurement; obtains the protein and energy of different brands of breast milk fortifiers; generates the number of bags of breast milk fortifier to be added based on the birth days and weight of the target premature infant, the amount of breast milk, breast milk protein, breast milk energy, the protein and energy of different brands of breast milk fortifiers, and the protein/energy ratio ingested by the premature infant; obtains the number of days of use of the breast milk fortifier and the blood urea nitrogen level of the target premature infant; and generates a strategy for adjusting the breast milk fortifier based on the grams of each bag of breast milk fortifier, the number of days of use of the breast milk fortifier, and the blood urea nitrogen level.

The acquisition of the birth information and current information of the target premature infant includes: the premature infant's birth day, weight, and daily feeding amount.

Determining the birth day, weight and daily feeding amount of the target premature infant based on the birth information and the current information includes: determining the daily feeding amount and weight of the target premature infant based on the birth information and the current information, for subsequent determination of whether a breast milk fortifier is needed.

The method of determining the protein and energy in breast milk based on instrumental measurement includes obtaining the protein and energy in the breast milk.

The target premature infant's weight and daily feeding amount are input into the system.

N=(W,M)

If W < 1.8 kg and M > W × 50, a human milk fortifier is required;

Wherein, N is the premature infant who needs to add breast milk fortifier, M is the amount of breast milk (mL), and W is the weight of the premature infant (kg).

The method is based on the target premature infant's days of birth, weight, daily feeding amount, breast milk protein, breast milk energy, protein and energy of different brands of breast milk fortifiers, and the protein/energy ratio consumed by the premature infant.

The protein content of different brands of breast milk fortifiers, the daily feeding amount, the target mother's breast milk protein, and the target mother's breast milk energy are input into the system, and the output is the number of breast milk fortifier bags D1 calculated based on breast milk analysis. The addition range includes:

The protein/energy range was 0.032-0.041;

D _min = (P _min * b * 0.01 * M + P _min * h - a * 0.01 * M - g) / (d - P _min * e *0.2389)

D _max = (P _max * b * 0.01 * M + P _max * h - a * 0.01 * M - g) / (d - P _max * e *0.2389)

Among them, the values of d, e, and f vary according to the brand of human milk fortifier, as shown in Table 1.

E _min = (b * M * 0.01) + (e * 0.2389 * D _min ) + h

If E _min >W * 100, output the value range of the number of breast milk fortifier bags D1 calculated based on breast milk analysis:

D _min <D1<=D _max

Wherein, D _max is the maximum number of bags of human milk fortifier required, D _min is the minimum number of bags of human milk fortifier required, D1 is the number of bags of human milk fortifier calculated based on human milk analysis, a is human milk protein (g/dL), b is human milk energy (kcal/dL), d is the protein of different brands of human milk fortifier (g/bag), e is the energy of different brands of human milk fortifier (kj/bag), g is other protein ingested by premature infants (g), and h is other energy ingested by premature infants (kcal). Generally, the default values of g and h are 0.

Furthermore, the obtaining of the grams of each bag of breast milk fortifier, the number of days the breast milk fortifier is used, and the blood urea nitrogen level of the target premature infant includes: the grams of each bag of breast milk fortifier, the number of days the breast milk fortifier is used, and the detection of the blood urea nitrogen level twice a week;

Furthermore, judging whether premature infants need to enter the full fortification stage based on the number of days of use of the breast milk fortifier and generating a strategy for adjusting the breast milk fortifier include: adjusting the amount of breast milk fortifier added based on the grams of each bag of breast milk fortifier and the detection of blood urea nitrogen levels twice a week, and determining whether additional protein needs to be added to premature infant breast milk:

If T1>3, it will enter the full-strengthening stage;

T1 is the number of days the human milk fortifier was used;

Enter the blood urea nitrogen of premature infants, the number of days of full fortification, and the grams per bag of different brands of human milk fortifiers into the system:

T2=T1-3

T2 is the number of days of full fortification, BUN is the blood urea nitrogen of premature infants, i, j, k are 3.5, 7, and 10.5 days, respectively, f is the grams of each bag of human milk fortifier, and D2 is the number of bags of human milk fortifier calculated based on the metabolic response of premature infants.

The strategy for adjusting the output human milk fortifier is shown in Table 2:

Table 2: Strategies for adjusting human milk fortifiers

The algorithm design of this system is based on the following: When P/E (protein/energy ratio) is 3.2~4.1 g/100kcal and energy intake is >100 kcal/(kg•d), it is close to the normal fetal intrauterine reference value. Then:

P = breast milk protein (g/dL) × 0.01 × breast milk volume (mL) + breast milk fortifier protein per bag (g/bag) × number of bags + other proteins (g)

E = breast milk energy (kcal/dL) × 0.01 × breast milk volume (mL) + energy per bag of breast milk fortifier (kj/bag) × 0.2389 × number of bags + other energy (kcal)

Combined with the following formula:

Breast milk volume (mL) = M

Breast milk protein (g/dL) = a

Protein per bag of human milk fortifier (g/bag) = d

Other protein (g) = g

Breast milk energy (kcal/dL) = b

Energy per bag of breast milk fortifier (kcal/bag) = e

Other energy (kcal) = h

Number of bags of human milk fortifier (bag) = D (D is unknown, the rest of the letters are known)

You can get:

P = a × 0.01 × M + d × D + g

E=b×0.01×M + e×0.2389×D + h

g is other protein intake by premature infants (g), and h is other energy intake by premature infants (kcal). For premature infants, the default values of g and h are 0.

According to (P/E) _min = 0.032, (P/E) _max = 0.041, we get:

D _min = (P _min * b * 0.01 * M + P _min * h - a * 0.01 * M - g) / (d - P _min * e *0.2389)

D _max = (P _max * b * 0.01 * M + P _max * h - a * 0.01 * M - g) / (d - P _max * e *0.2389)

The creativity of this application lies in providing an individualized scientific algorithm for the use of breast milk fortifiers for premature infants, and designing a complete management system based on the algorithm. Based on this system, specific breast milk fortifier usage is given for different premature infants, which can not only improve the pertinence and effectiveness of nutritional support, but also reflect the trend of refined and humanized nutritional support. This system is easy to use and takes little time.

The above-mentioned embodiments only express several implementation methods of the present invention, and the descriptions thereof are relatively specific and detailed, but they cannot be understood as limiting the scope of the patent of the present invention. It should be pointed out that, for ordinary technicians in this field, several modifications and improvements can be made without departing from the concept of the present invention, which are all within the scope of protection of the present invention. Therefore, the scope of protection of the patent of the present invention shall be based on the attached claims.

Claims (6)

1. A personalized management system for premature infant breast milk fortifier, characterized in that it includes an information acquisition module, a breast milk content analysis module, a blood urea nitrogen measurement module, and a strategy generation module; wherein: Information acquisition module: obtain the birth date, weight and breast milk feeding amount of the target premature infant; obtain the protein and energy of different brands of breast milk fortifiers; Breast milk content analysis module: measures the protein and breast milk energy in the target mother’s breast milk; Blood urea nitrogen measurement module: after the target premature infant uses the breast milk fortifier, the blood urea nitrogen measurement module monitors the blood urea nitrogen level of the target premature infant; Strategy generation module: Generates the number of bags of human milk fortifier to be added based on the birth days and weight of the target premature infants, breast milk volume, breast milk protein, breast milk energy, protein and energy of different brands of breast milk fortifiers, and protein/energy ratio of premature infants; generates strategies for adjusting breast milk fortifiers based on the grams of breast milk fortifier per bag, the number of days the breast milk fortifier is used, and the blood urea nitrogen level; The strategy generation module determines: If the premature infant's weight is less than 1.8 kg, and the amount of breast milk is greater than 50 times the premature infant's weight, it is determined that the premature infant needs to use a breast milk fortifier; further determination: If E _min > 100 times the premature infant's weight, the number of bags of human milk fortifier D ₁ calculated based on human milk analysis is output, where: E _min = (b * M * 0.01) + (e * 0.2389 * D _min ) + h b is breast milk energy, in kcal/dL; M is breast milk volume, in mL; D _min is the minimum number of bags of breast milk fortifier required; h is other energy intake by premature infants, and h is 0; The strategy generation module calculates the number of bags of breast milk fortifier to be added by the following formula: D _min = (P _min * b * 0.01 * M + P _min * h - a * 0.01 * M - g) / (d - P _min * e *0.2389) D _max = (P _max * b * 0.01 * M + P _max * h - a * 0.01 * M - g) / (d - P _max * e *0.2389) D _min < D1 < D _max Where: D _max is the maximum number of bags of breast milk fortifier required, D _min is the minimum number of bags of breast milk fortifier required, D1 is the number of bags of breast milk fortifier calculated based on breast milk analysis; P _max represents the maximum value of protein/energy ratio, P _min represents the minimum value of protein/energy ratio; a is breast milk protein, unit g/dL; b is breast milk energy, unit kcal/dL; d is the protein of different brands of breast milk fortifier, unit g/bag; e is the energy of different brands of breast milk fortifier, unit kj/bag; g is other protein ingested by premature infants, unit g; h is other energy ingested by premature infants, unit kcal; g and h values are 0; The strategy generation module generates a strategy for adjusting the human milk fortifier based on the grams of human milk fortifier per bag, the number of days the human milk fortifier is used, and the blood urea nitrogen level: Case 1: T2>k, and BUN<10 mg/dL; Output: D2 bags of human milk fortifier and 1.2g of additional protein are needed; D2 = (M ÷ 100) * 5 ÷ f; Case 2: T2>j, and BUN<10 mg/dL; Output: D2 bags of human milk fortifier and 0.8g of additional protein are needed; D2 = (M ÷ 100) * 5 ÷ f; Case 3: T2＞i, and BUN＜10 mg/dL; Output: D2 bags of human milk fortifier and 0.4g of additional protein are needed; D2= (M ÷ 100)*5 ÷ f; Case 4: 1≤T2≤i, and 10＜BUN＜16 mg/dL; then output: D2 bags of human milk fortifier are needed; D2 = M ÷ 20÷ f; Case 5: T2＞i, and BUN＞16 mg/dL; then output: D2 bags of human milk fortifier are needed; D2 = (M ÷ 100)*3.75 ÷f; Case 6: T2＞j, and BUN＞16 mg/dL; then output: D2 bags of human milk fortifier are needed; D2 = (M ÷ 100)*2.5 ÷f; Wherein, i, j, and k are 3.5, 7, and 10.5 days, respectively; f is the weight of each bag of human milk fortifier in grams; D2 is the number of bags of human milk fortifier calculated based on the metabolic response of premature infants; T1 is the number of days the human milk fortifier is used; T2 is the number of days the human milk fortifier is fully fortified; T2=T1-3; BUN is the blood urea nitrogen of premature infants. 2. The system according to claim 1, characterized in that P _max =0.041, P _min =0.032. 3. The system according to claim 1 is characterized in that situation 1 corresponds to level 3 reinforcement, situation 2 corresponds to level 2 reinforcement, situation 3 corresponds to level 1 reinforcement, situation 4 corresponds to level 0 reinforcement, situation 5 corresponds to level -1 reinforcement, and situation 6 corresponds to level -2 reinforcement. 4. The system according to claim 1, characterized in that the measurement time of the blood urea nitrogen measurement module is 3.5 days, 7 days and 10.5 days after the use of the human milk fortifier. 5. The system according to claim 1, characterized in that the breast milk content analysis module measures the protein and breast milk energy in the breast milk through a breast milk analyzer. 6. The system according to claim 1, wherein the protein and energy of different brands of human milk fortifiers are obtained by referring to product instructions or measured by a human milk analyzer.