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Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study

Journal of Perinatology volume 32, pages 205–209 (2012)Cite this article

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Abstract

Objective:

The purpose of this randomized pilot study was to collect preliminary data regarding the feasibility and effects of early initiation of milk expression on the onset of lactogenesis stage II and milk volume in mothers of very low birth weight (VLBW) infants.

Study Design:

Twenty women were randomized to initiate milk expression within 60 min (group 1) or 1 to 6 h (group 2) following delivery. Milk volume and timing of lactogenesis stage II was compared between groups using Wilcoxon's rank sum tests.

Result:

Group 1 produced statistically significantly more milk than group 2 during the first 7 days (P=0.05) and at week 3 (P=0.01). Group 1 also demonstrated a significantly earlier lactogenesis stage II (P=0.03).

Conclusion:

Initiation of milk expression within 1 h following delivery increases milk volume and decreases time to lactogenesis stage II in mothers of VLBW infants.

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References

  1. AAP. American Academy of Pediatrics policy statement: breastfeeding and the use of human milk. Pediatrics 2005; 115 (2): 496–506.

    Article  Google Scholar 

  2. USDHHS. US Department of Health and Human Services. Healthy People 2020. Government Printing Office: Washington, 2010.

  3. Ronnestad A, Abrahamsen TG, Medbo S, Reigstad H, Lossius K, Kaaresen PI et al. Late-onset septicemia in a Norwegian national cohort of extremely premature infants receiving very early human milk feedings. Pediatrics 2005; 15 (3): 169–276.

    Google Scholar 

  4. Sisk PM, Lovelady CA, Dillard RG, Gruber KJ, O'Shea TM . Early human milk feedings is associated with a lower risk of necrotizing enterocolotis in very low birth weight infants. J Perinatol 2007; 127: 1–6.

    Google Scholar 

  5. Sisk PM, Lovelady CA, Gruber KJ, Dillard RG, O'Shea TM . Human milk consumption and full enteral feeding among infants who weigh <1250 grams. Pediatrics 2008; 121: 1528–1533.

    Article  Google Scholar 

  6. Schanler RJ, Shulman RJ, Lau C . Feeding strategies for premature infants: beneficial outcome of feeding fortified human milk versus preterm formula. Pediatrics 1999; 103: 1150–1157.

    Article  CAS  Google Scholar 

  7. Vohr BR, Poindexter BB, Dusick AM . Beneficial effects of breast milk in the neonatal intensive care unit on the developmental outcome of extremely low birth weight infants at 18 months of age. Pediatrics 2006; 118: 115–123.

    Article  Google Scholar 

  8. Neville MC, Morton JA, Umemora S . Lactogenesis: the transition between pregnancy and lactation. Pediatr Clin North Am 2001; 48: 35–52.

    Article  CAS  Google Scholar 

  9. Kuhn NJ . The Biochemistry of Lactogenesis. Elsevier: Amsterdam, 1983.

    Google Scholar 

  10. Dewey KG, Nommsen-Rivers LA, Heinig MJ, Cohen RJ . Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. Pediatrics 2003; 112 (3): 607–619.

    Article  Google Scholar 

  11. Chapman DJ, Perez-Escamilla R . Identification of risk factors for delayed onset of lactation. J Am Diet Assoc 1999; 99: 450–454.

    Article  CAS  Google Scholar 

  12. Sievers E, Haase S, Oldigs HD, Schaub J . The impact of peripartum factors on the onset and duration of lacatation. Biol Neonate 2003; 83: 246–252.

    Article  CAS  Google Scholar 

  13. Chen A, Nommsen-Rivers LA, Dewey KG, Lonnerdal B . Stress during labor and delivery and early lactation performance. Am J Clin Nutr 1998; 68: 335–344.

    Article  CAS  Google Scholar 

  14. Neubauer SH, Ferris AM, Chase CG, Fanelli J, Thompson CA, Lammi-Keefe CJ et al. Delayed lactogenesis in women with insulin-dependent diabetes mellitus. Am J C Nutr 1993; 58 (1): 54–60.

    Article  CAS  Google Scholar 

  15. Cregan MD, de Mallo TR, Kershaw D . Initiation of laction in women after preterm delivery. Acta Obstet Gynecol Scand 2002; 81: 870–877.

    Article  Google Scholar 

  16. Ryan A, Wenjun Z, Acosta A . Breastfeeding continues to increase into the new millennium. Pediatrics 2002; 110: 1103–1109.

    Article  Google Scholar 

  17. Hill PD, Ledbetter RJ, Kavanaugh K . Breastfeeding patterns of low birth weight infants after hospital discharge. J Obstet Gynecol Neonatal Nurs 1997; 26: 189–197.

    Article  CAS  Google Scholar 

  18. Hill PD, Aldag JC, Chatterton RT, Zinaman M . Comparison of milk output between mothers of preterm and term infants: the first 6 weeks after birth. J Hum Lact 2005; 21 (1): 22–30.

    Article  Google Scholar 

  19. Hill PD, Aldag JC, Chatterton RT, Zinaman M . Primary and secondary mediators influence on milk output in lactating mothers of preterm and term infants. J Hum Lact 2005; 21 (2): 138–150.

    Article  Google Scholar 

  20. Chatterton RT, Hill PD, Aldag JC, Hodges KR, Bellknap SM, Zinaman M . Relation of plasma oxytocin and prolactin concentrations to milk production in mothers of preterm infants: influence of stress. J Clin Endocrinol Metab 2000; 85: 3661–3668.

    CAS  Google Scholar 

  21. Newton N . The relation of the milk-ejection reflex to the ability to breast feed. Ann N Y Acad Sci 1992; 652: 484–486.

    Article  CAS  Google Scholar 

  22. Jain L, Sivieri E, Abbasi S, Bhutani V . Energetics and mechanics of nutritive sucking in the preterm and term neonate. J Pediatr 1987; 111: 894–898.

    Article  CAS  Google Scholar 

  23. Lawson K, Tulloch MI . Breastfeeding duration: prenatal intentions and postnatal practices. J Adv Nurs 1995; 22: 841–849.

    Article  CAS  Google Scholar 

  24. Berra S, Sabulsky J, Rajmil L, Passamonte R, Pronsato J, Butinof M . Correlates of breastfeeding duration in an urban cohort from Argentina. Acta Paediatr 2003; 92: 952–957.

    Article  CAS  Google Scholar 

  25. Murray EK, Ricketts S, Dellaport J . Hospital practices that increase breastfeeding duration: results from a population-based study. Birth 2006; 34 (3): 202–210.

    Article  Google Scholar 

  26. Furman L, Minich N, Hack M . Correlates of lactation in mothers of very low birth weight infants. Pediatrics 2002; 109 (4): 57–62.

    Article  Google Scholar 

  27. Hill PD, Aldag JC, Chatterton RT . Effects of pumping style on milk production in mothers of non-nursing preterm infant. J Hum Lact 1999; 15 (3): 209–216.

    Article  CAS  Google Scholar 

  28. Hill PD, Aldag JC, Chatterton RT, Zinaman M . Comparison of milk output between mothers of preterm and term infants: the first 6 weeks after birth. J Hum Lact 2005; 21 (1): 22–30.

    Article  Google Scholar 

  29. Hopkinson JM, Schanler RJ, Garza C . Milk production by mothers of premature infant. Pediatrics 1988; 61 (6): 815–820.

    Google Scholar 

  30. Hill PD, Brown LP, Harker RL . Initiation and frequency of breast expression in breastfeeding mothers of LBW and VLBW infants. Nurs Res 1995; 44 (5): 352–355.

    CAS  Google Scholar 

  31. Arthur PG, Smith M, Hartmann PE . Milk lactose, citrate, and glucose as markers of lactogenesis in normal and diabetic women. J Pediatr Gastroenterol Nutr 1989; 488: 296–496.

    Google Scholar 

  32. Haase B, Barreira J, Murphy PK, Mueller M, Rhodes J . The development of an accurate test weighing technique for preterm and high-risk hospitalized infants. Breastfeed Med 2009; 4 (3): 151–156.

    Article  Google Scholar 

  33. Chapman DJ, Perez-Escamilla R . Maternal perception of the onset of lactation is a valid, public health indicator of lactogenesis stage II. J Nutr 2000; 130: 2972–2980.

    Article  CAS  Google Scholar 

  34. Henderson JJ, Hartmann PE, Newnham JP, Simmer K . Effect of preterm birth and antenatal corticosteriod treatment on lactogenesis II in women. Pediatrics 2008; 121 (1): 92–100.

    Article  Google Scholar 

  35. Neville MC, Keller RP, Seacat J, Lutes V, Neifert M, Casey C et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation. Am J Clin Nutr 1988; 48: 1375–1386.

    Article  CAS  Google Scholar 

  36. Saint L, Smith M, Hartmann PE . The yield and nutrient content of colostrum and milk of women from giving birth to 1 month post-partum. Br J Nutr 1984; 52: 87–95.

    Article  CAS  Google Scholar 

  37. Neville MC, Morton JA, Umemora S . Lactogenesis: the transition between pregnancy and lactation. Pediatr Clin North Am 2001; 48: 35–52.

    Article  CAS  Google Scholar 

  38. Lau C, Hurst NM, Smith EO, Schanler R . Ethnic/racial diversity, maternal stress, lactation and very low birth weight infants. J Perinatol 2007; 27: 399–408.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. University of Florida, Gainesville, FL, USA

    L A Parker, S Sullivan & C Krueger

  2. Medical University of South Carolina, Columbia, SC, USA

    T Kelechi & M Mueller

Authors
  1. L A Parker
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  2. S Sullivan
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  3. C Krueger
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  4. T Kelechi
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  5. M Mueller
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Correspondence to L A Parker.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Parker, L., Sullivan, S., Krueger, C. et al. Effect of early breast milk expression on milk volume and timing of lactogenesis stage II among mothers of very low birth weight infants: a pilot study. J Perinatol 32, 205–209 (2012). https://doi.org/10.1038/jp.2011.78

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