Feasibility of Standardized Human Milk Collection in Neonatal Care Units

Laura Galante,Amber M Milan,Mark H Vickers,Frank H Bloomfield,Shikha Pundir,Tanith Alexander,Clare M Reynolds

doi:10.1038/s41598-019-50560-y

Laura Galante, Amber M Milan + Show 5 more

Open Access

https://doi.org/10.1038/s41598-019-50560-y

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Abstract

Research in human lactation is a growing field. However, difficulties in studying human milk originate from the dynamicity of its composition. Using standardized collection protocols is mandatory to minimize variation and warrant comparability of findings across different studies. Yet, information on the feasibility of collecting human milk with standardized procedures, especially in neonatal units, are lacking. The present study aims to report on the feasibility and difficulties to collect human milk according to a standardized protocol, during early lactation from women who gave birth to preterm infants. Human milk was collected from 129 mothers of moderate- to late-preterm infants according to two variations of a standard protocol which differed for number of collection time-points. Collection rates and adherence to the sampling protocol were evaluated together with reason for missed collection. Collection of ≥1 sample was successful for 80% of the mothers. However adherence to the standard protocol was overall low (36% and 27%). Collection rates were different between the two protocol variations (73% against 92%, p ≤ 0.001). Amongst the reason for missed collection, low milk supply was the most recurrent (40%). Our findings show that while collecting human milk in neonatal units is achievable, obtaining standard and comparable samples results challenging.

Highlights

The impact of collection method on HM analysis was first described in 19829
The difficulty in standardizing collection increases in settings such as neonatal care units (NCU, including neonatal intensive care units or special care baby units) where many factors, especially those associated with preterm birth, can obstruct or delay lactogenesis[17]
2018, 20 mothers had been enrolled in the study prior to the start of HM collection in the NCU, five mothers withdrew their infants from the study and two mothers withdrew from HM collection

Summary

Introduction

The impact of collection method on HM analysis was first described in 19829. Since few studies have investigated the effect of different collection methods (hand-expression versus breast pump-expression), storage containers (pyrex versus polypropylene), storage temperature and time to laboratory analysis, suggesting that expressed volumes of HM are dependent upon the specific collection method and that storage containers and sample storage conditions impact HM composition[10,11]. The difficulty in standardizing collection increases in settings such as neonatal care units (NCU, including neonatal intensive care units or special care baby units) where many factors, especially those associated with preterm birth, can obstruct or delay lactogenesis[17]. In such environments, any HM produced by mothers is extremely important for the infants[18], as it reduces morbidity and mortality in preterm and very low birthweight infants[19,20]. The present study reports our experience and barriers in trying to standardize HM sample collection in the NCU from mothers of moderate- to late-preterm infants, soon after birth

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