Breast Pump Research Articles

Perceptions, practices, and associated factors towards expressed breastfeeding among mothers in Jakarta, Indonesia

Background Expression of breast milk is a strategy to ensures continuous breastfeeding during temporary separation of infant from the mother. Handling and storage of expressed breast milk (EBM) should be based on established recommendations because these practices can affect milk quality and safety. Objective To describe perceptions and practices of EBM handling and storage, compare with commonly used recommendations and associated factors influencing these practices among mothers in Jakarta, Indonesia, Methods Mothers who practiced expressed breastfeeding (EBF) to their 6-12 weeks-old infants completed questionnaires about their peceptions and practices on how they handle and storage EBM. The differences in perceptions and practices about expressed breastfeeding management were analyzed using the Chi-square or Fisher's exact test. Results Among 30 mothers, 14/30 gave EBF exclusively, 19/30 used breast pump, and 26/30 expressed ³6 times/day. Infants in this study received expressed milk 5-10 times per day. Maternal age and resource of information were factors significantly associated with mother’s perceptions, while maternal age, education, and parity were significantly associated with the practices of EBM handling and storage. Conclusion This study reveals inconsistent perceptions and practices on expressed milk handling and storage by the mothers. They have good knowledge about the theoretical aspects of expressed breastfeeding, but some other techniques are poor, which can be detrimental to the health of the infants. Further study is needed to find more efficient and optimal methods of expressed milk handling and storage, necessitating thoughtful consideration of better practices and recommendations.

An evaluation of patient comfort levels during expression with a modified pumping program: a prospective proof of concept study.

This study aimed to assess if the implementation of a gentle transition of vacuum mode into a breast pump suction pattern commonly used to initiate milk production would improve user comfort while expressing during the first four days postpartum. This prospective study was conducted at OLVG hospital in the Netherlands in two sequential phases. Breastfeeding patients delivering >36 weeks gestation with an infant aged ≤96 h old and a clinical indication to express milk with a breast pump were recruited. Intervention group 1 (n = 40) used a hospital-grade electric breast pump with a standard breast pump suction pattern. Intervention group 2 used a hospital-grade electric breast pump with a modified breast pump suction pattern (n = 40). The primary outcome was an objective assessment of comfort as measured by participants' need to reduce vacuum level during the 20 min test session. Secondary outcomes included the total expression volume (ml) in 20 min pumping. The study found that the primary outcome of comfort was significantly improved with the modified breast pump suction pattern compared to the standard pattern (OR 1.29, 95% CI 1.08 to 1.6) with 86% vs. 67% of participants not needing to reduce applied vacuum levels. The amount of milk expressed did not differ significantly between phases (group 1: 7.6 ml (2.7-25.5 ml), group 2: 12.0 ml (1.2-31.5 ml), p = 0.43). This study is the first to demonstrate an improvement in user comfort driven by the implementation of gentle transitions in vacuum modes in a commonly used breast pump suction pattern. Research into this novel population combining both pumping and breastfeeding in the first days after birth offers new unique insights on the requirements of breast pump suction patterns. Registered on clinical trials.gov NCT04619212. Date of registration November 6, 2020.

Feasibility Study of an Assistive Garment for Providing Kangaroo Mother Care to Preterm Neonates

Objective of the study: This study was undertaken to test the feasibility and acceptability of an assistive garment for providing Kangaroo mother care (KMC) among mothers of preterm neonates. Study design: An interventional case series design was planned and eight mothers and their babies were recruited using convenience sampling. Feasibility outcomes were assessed using a validated log sheet. Acceptability outcomes were collected by a five-point attitude scale, from the mothers. Results: The garment supported the baby’s weight and maintained the position of the baby during KMC in all the sessions. Six mothers could express breast milk using a breast pump while using the garment. Most of the mothers voiced positive opinions about the garment.

Are You Knowledgeable About Breast Pump Safety and Assessment? Knowledge and Skills for Clinical Practice

Objective:There is a lack of evidence or practice guidelines surrounding safe and effective breast pump use. Many lactation personnel feel ill-prepared when troubleshooting pumps. There is an emerging need for skills and understanding on breast pumps and their association with lactation problems.Methods:A review of literature, current professional practice, and clinical experience was used to gain perspective on the current state of breast pump safety and use.Results:More mothers are using breast pumps to initiate, stimulate, or maintain their milk supply. Gaps were identified surrounding breast pump safety and effectiveness. The breast pump market is lucrative and is being flooded with new and “better” pumps at a rapid rate. Pump testing for safety and effectiveness is suboptimal. An increase in breast injuries, illness, and milk supply issues is emerging in clinical practice. There are currently no consistent standards for optimal pressures, cycling, or flange fit.Conclusions:Pumps are a viable option for mothers and can play a role in lactation continuation. Lactation personnel must have competent knowledge and skills to help mothers use pumps safely and effectively.

An innovative low-cost breast pump-hire program to enhance breastfeeding rates in a neonatal intensive care unit.

To evaluate the outcomes of a low-cost hospital-grade breast pump hire program for women experiencing financial hardship with infants in neonatal intensive care. A multi-method evaluation including data audits and surveys. Twenty-four electric breast pumps were purchased and rented to mothers at a cost of $1/day. To be eligible, mothers needed to have given birth to an infant <32 weeks and/or <1500 g and self-identified as experiencing financial hardship. Data were collected by (1) a retrospective audit to evaluate infant feeding and clinical outcomes at hospital discharge; (2) prospective telephone surveys to evaluate women's satisfaction with the program; and (3) analysis of the breast pump register to determine any loss or damages. Twenty-four mothers of 26 infants participated in the program. More than half of the infants were exclusively breastmilk fed at hospital discharge, and more than three-quarters were fed a combination of breastmilk and formula. Women who intended to formula feed were supported to provide breastmilk to their infants in the first few weeks of life. Most participants were highly satisfied with the program. Women reported that accessibility to a hospital-grade breast pump improved their ability to provide expressed breastmilk to their infants. Most participants were 'extremely satisfied' with the performance of the breast pump. One-quarter of the women reported that they would have exclusively formula-fed if they did not have access to the breast pump hire program. The audit of the equipment register showed no reported technical issues, loss or damages. The findings suggested that the low-cost breast pump hire program supported equitable care, increasing women's ability to provide expressed breastmilk for their infants. Providing access to low-cost hospital-grade breast pumps to mothers of vulnerable infants is likely to prevent poor infant clinical outcomes and improve women's care satisfaction. Nil.

Pumps: A Possible Tool to Promote More Equitable Lactation Outcomes.

Pregnant individuals and infants in the US are experiencing rising morbidity and mortality rates. Breastfeeding is a cost-effective intervention associated with a lower risk of health conditions driving dyadic morbidity and mortality, including cardiometabolic disease and sudden infant death. Pregnant individuals and infants from racial/ethnic subgroups facing the highest risk of mortality also have the lowest breastfeeding rates, likely reflective of generational socioeconomic marginalization and its impact on health outcomes. Promoting breastfeeding among groups with the lowest rates could improve the health of dyads with the greatest health risk and facilitate more equitable, person-centered lactation outcomes. Multiple barriers to lactation initiation and duration exist for families who have been socioeconomically marginalized by health and public systems. These include the lack of paid parental leave, increased access to subsidized human milk substitutes, and reduced access to professional and lay breastfeeding expertise. Breast pumps have the potential to mitigate these barriers, making breastfeeding more accessible to all interested dyads. In 2012, The Patient Protection and Affordable Care Act (ACA) greatly expanded access to pumps through the preventative services mandate, with a single pump now available to most US families. Despite their near ubiquitous use among lactating individuals, little research has been conducted on how and when to use pumps appropriately to optimize breastfeeding outcomes. There is a timely and critical need for policy, scholarship, and education around pump use given their widespread provision and potential to promote equity for those families facing the greatest barriers to achieving their personal breastfeeding goals.

Time intervals between pumping did not affect breastmilk protein produced by mothers of preterm infants.

Few studies investigate factors that might influence the content of expressed breastmilk. This study aims to investigate the influence of the intervals between breastmilk pumping and the time of the day on protein and fat concentration in breastmilk. Mothers of very preterm infants in a neonatal ward who expressed more than 400 mL per day were included. Expressed breastmilk was obtained from each mother over 30 h who were pumping at strictly planned and varying intervals: 2, 3, 4 and 6 h. All samples were analysed using infrared transmission spectroscopy. Ten mothers participated at a median of 22 days postpartum. A total of 176 milk samples were analysed, and the average protein and fat concentrations in g/100 mL were 1.1 ± 0.23 and 4.2 ± 1.3, respectively. The time intervals between breast pumping sessions did not impact protein content, but fat content decreased by longer intervals (p < 0.01). The time of the day for milk pumping did not influence the protein or fat content. A single milk sample collected after any 2-6 h interval, at any time during the day, represents the protein content in the breastmilk, but not the fat content which decreased with longer intervals.

Women's Perception Regarding Breastfeeding Support in Workplace: A Scoping Review

Background: Newborns mostly require breast milk. Women who choose to work are equally responsible for maintaining breastfeeding. Prior studies have identified variations in the time and intensity of breastfeeding before and after returning to work. Disparities exist in the assistance provided for women to breastfeed in the workplace, with past studies revealing insufficient facilities. This study intends to examine women's views on the support for breastfeeding in the workplace.Method: A scoping review was carried out using the PubMed, Google Scholar, and ScienceDirect databases, following PRISMA procedures. The papers were selected based on specific criteria: they had to be cross-sectional and qualitative studies focusing on women's opinions of breastfeeding in the workplace. Additionally, the articles were to be written in English, give the entire text, and have been done between 2019 and 2023.Results: Ten publications were examined from different workplaces. The research examines different forms of work and workplaces. Women's views on breastfeeding support focus on instrumental support, such as inappropriate or unavailable lactation rooms, work hours and policies, lack of breastfeeding groups, facilities for breastfeeding and breast milk pumping, insufficient storage, inadequate childcare facilities, and lack of caregivers at home, which impede exclusive breastfeeding. Emotional support refers to the assistance provided by colleagues in the workplace. Form of information support, namely the absence of communication and information support. There is a common belief that breastfeeding is seen as a personal issue connected to one's knowledge and self-confidence. Cross-sectoral collaboration needs to be involved, including family, workplace commitment, and government support to support the success of breastfeeding in the workplace.

Survey of Lactating Anesthesiologists Using Wearable Breast Milk Pumps While Working in Operating Rooms and Other Clinical Settings.

We performed a prospective Internet survey study of anesthesiologists lactating in 2022 or 2023. Approximately half (48%, 75 of 156) lacked convenient dedicated lactation space and approximately half (55%, 86 of 155) used a wearable breast pump. The vast majority using a wearable pump did so in clinical settings, including operating rooms (88%, 76 of 86). When using during cases, approximately half reported that milk production was sufficient to substitute for lactation pumping sessions (52%, 39 of 75). Based on probability distributions of surgical times, future research can evaluate the usefulness of wearable pumps based on the objective of reducing anesthesiologists' durations of lactation sessions to <15 minutes.

Barriers to care and treatment experiences among individuals with postpartum psychosis.

Postpartum psychosis (PP) is a severe psychiatric disorder affecting 1-2 per 1,000 deliveries. Prompt access to healthcare and timely initiation of treatment are crucial to minimizing harm and improving outcomes. This analysis seeks to fill gaps in knowledge surrounding barriers to care and treatment experiences among this population. Participants were individuals with histories of PP who enrolled in the Massachusetts General Hospital Postpartum Psychosis Project (MGHP3). The MGHP3 Healthcare Access Survey, a cross-sectional questionnaire, assesses barriers to care, treatment-seeking behaviors, and experiences with treatment. Descriptive statistics were utilized to describe sample characteristics. 139 participants provided 146 episode-specific survey responses. Lack of available services was cited as the greatest barrier to care for PP. Among those who sought treatment, obstetric providers (34.5%) and emergency medical professionals (29.4%) were the most common initial points of contact. 82.2% of the respondents went to an emergency room or crisis center during their episode(s). Most (61.8%) reported being given insufficient information to manage their PP. Approximately half of participants were hospitalized (55.5%), the majority of whom had no access to their infant during hospitalization (70.4%). Of those breastfeeding or pumping at admission, 31.3% were not given access to a breast pump. 44.4% dealt with delivery-related medical issues during their hospitalization. This report is the first of its kind to assess key public health domains among individuals with PP. Findings point to several directions for future research and clinical practice to improve treatment timeliness and quality, potentially improving long-term outcomes related to this serious illness.

Elevation of Depressed Skull Fracture in Neonates Using a Breast Pump and a Custom-Molded Flange.

"Ping-pong fractures" (PPF) can occur in neonates and result in cosmetic deformity and local mass effect. Standard treatment involves surgical elevation of the depressed bone when the indentation is considerable or cosmetically apparent. Surgical correction of PPF subjects patients to the risks of surgery and general anesthesia. This article and corresponding video demonstrate a novel means of correcting PPF at bedside without surgery or anesthesia. We used a hospital-grade breast pump connected to a custom-fabricated flange to successfully elevate PPF in two neonates. Two moderately preterm infants were noted at birth to have large parietal PPF. To avoid surgical intervention, elevation using a suction device was attempted. A hospital-grade breast pump was used to provide suction. A custom device was fabricated out of a breast pump flange and molded Coloplast Brava® protective seal rings. This device was carefully applied to the skull to exactly match the diameter of the PPF and contour of the bone. Brief (15-30 seconds) periods of suction were applied several times until the PPF was successfully elevated as documented on subsequent computed tomography scans. Both infants achieved excellent cosmetic results with no adverse effects over 24- and 9-month follow-ups, respectively. This technique eliminates the risks of open surgical correction and corrected the PPF without general anesthesia or adverse effects to the infant. While there may be limitations due to patient age and/or location of the PPF, the use of widely available and inexpensive custom-fitted materials with a hospital grade breast pump achieves maximal efficacy without requiring higher negative pressure suction application. Elevation of PPF can be safely achieved in some neonates using readily available equipment: a hospital-grade breast pump, flange, and moldable adherent material. This technique is reasonable to attempt in lieu of surgical elevation.

Where does the time go? Temporal patterns of pumping behaviors in mothers of very preterm infants vary by sociodemographic and clinical factors.

Mothers of very preterm (<32 weeks gestational age [GA]) infants are breast pump dependent and have shorter duration of milk provision than mothers of term infants. The opportunity (i.e., time) cost of pumping and transporting mother's own milk (MOM) from home to the NICU may be a barrier. There is a paucity of data regarding how much time mothers actually spend pumping. To investigate the variation in pumping behavior by postpartum week, maternal characteristics, and infant GA. Prospectively collected pump log data from mothers enrolled in ReDiMOM (Reducing Disparity in Mother's Own Milk) randomized, controlled trial included pumping date and start time and end time of each pumping session for the first 10 weeks postpartum or until the infant was discharged from the NICU, whichever occurred first. Outcomes included number of daily pumping sessions, number of minutes spent pumping per day, and pumping behaviors during 24-h periods, aggregated to the postpartum week. Medians (interquartile ranges) were used to describe outcomes overall, and by maternal characteristics and infant GA. Data included 13,994 pump sessions from 75 mothers. Maternal characteristics included 55% Black, 35% Hispanic, and 11% White and 44% <30 years old. The majority (56%) of infants were born at GA 28-31 weeks. Mothers pumped an average of less than 4 times per day, peaking in postpartum week 2. After accounting for mothers who stopped pumping, there was a gradual decrease in daily pumping minutes between postpartum weeks 2 (89 min) and 10 (46 min). Black mothers pumped fewer times daily than non-Black mothers after the first 2 weeks postpartum. On average mothers pumped less intensively than the minimum recommendation of 8 times and 100 min per day. However, these pumping behaviors represent significant maternal opportunity costs that should be valued by the institution and society at large.

Changes in the Concentration of fat, Protein and Carbohydrates During the Excretion of Milk by Vacuum Breast Pump and Breast Pump with Compression

Background: The purpose of the work is to investigate the contents of the main nutrients of milk (fat, protein, lactose), as well as the energy value of milk in the process of expression milk using an vacuum electric breast pump and vacuum electric breast pump with compression pulses simultaneously. Method: Surveys were conducted on 9 women 5-8 weeks of lactation. The analysis was carried out in 10 ml samples of milk, which were continuously expression with breast pump «Laktopuls»: only with vacuum stimuli, and simultaneously with vacuum and compression stimuli. The sampling continuity was ensured by a specially developed procedure. Milk analysis in the samples was performed 1-1.5 hours after gland expression on a Miris AB Uppsala, Sweden, human milk analyzer. Finding: The largest changes in milk samples were observed in fat concentration. The fat content in milk increased in each subsequent sample and in the latter samples could exceed its content in the initial samples by 3-4 times. The total amount of fat was about 25% more when milk ejected by breast pump with vacuum and compression stimuli than with vacuum stimulus only. When determining the protein concentration in milk samples, an increase in its concentration was also found during milk ejection, but on 10-20%. In contrast to the dynamics of fat and protein concentrations, the carbohydrate concentration did not change in all women during the milk ejection. Conclusion: A method has been developed that allows analyzing milk nutrients during the continuous removal of milk from the gland. Surveys have shown that ejection of milk with breast pump with vacuum and compression stimuli, increases the amount of fat and protein in breast milk.

Kelas Edukasi Menyusui Ibu Hamil (KEMIH): Its Correlation to The Improvement of Knowledge, Self-Efficacy, and Breast Milk Production of Post-Partum Mothers

There have been many educational programs or media used to introduce exclusive breastfeeding. However, the reality in the field shows that many people, especially mothers, still do not understand exclusive breastfeeding. Moreover, many mothers who have been educated continue to give formula milk because of misunderstandings, such as myths. For this reason, strengthening mothers’ self-efficacy needs to be carried out since it is one of the determining factors for the success of exclusive breastfeeding. Therefore, it is highly necessary to have a maternal assistance program that starts during pregnancy to strengthen the mother’s self-efficacy and continues to guide the mother after giving birth in exclusive breastfeeding. The objective of this study was to assess the effectiveness of Kelas Edukasi Menyusui Ibu Hamil (KEMIH) (English: The Breastfeeding Education Class for Pregnant Women) to increase knowledge, self-efficacy, and breast milk production of post-partum mothers. In this study, the researchers applied a quasi-experimental design. In addition, the employed approach was two groups with control. The number of samples was 61 respondents who met the pre-defined criteria (29 respondents in the intervention group and 31 respondents in the control group). The instruments in this study were modules, self-efficacy questionnaires, and electric breast pumps. The results showed that there were significant differences in the three variables, in which the obtained p-values were 0.000 (&lt; 0.05) for the increase in knowledge, 0.012 (&lt; 0.05) for the increase in mother’s self-efficacy, and 0.000 (&lt; 0.05) for the increase in breast milk production. This indicates that the KEMIH program is effective for increasing the knowledge, self-efficacy, and breast milk production of mothers. In addition to education programs, mothers need to have strong support from their families and health workers for the success of the breastfeeding process

Premarket Notifications and Patents for Breast Pumps Before and After the ACA

This study investigates whether ACA policies to increase access to breast pumps and lactation care were associated with innovation in the market for breast pumps.

Breastfeeding support among re-hospitalized young children: a survey from Italy

BackgroundIn 2021, the Task Force on Breastfeeding of the Italian Ministry of Health released a document calling for the provision of breastfeeding support in case of re-hospitalization of the child after birth. Since type and quality of breastfeeding support during re-hospitalization in Italian Pediatric Units (PUs) is largely unknown, the Breastfeeding Section of the Italian Society of Pediatrics (TASIP) conducted an ad hoc national survey.MethodsIn March 2023, a specifically designed electronic questionnaire was sent to the Directors of 328 PUs, who were requested to fill it online.ResultsData from 161 PUs were received, with a response rate of 48.7%. Our results highlighted that 18.6% of units do not provide training on breastfeeding for healthcare professionals and 46% of PUs lack of an ad hoc policy on breastfeeding support in case of re-hospitalization of the child. Although 88.2% of PUs provide breast pumps to the mothers of the re-hospitalized young children, 34.8% lack of a protocol on the storage of expressed breast milk.ConclusionsBreastfeeding support for the mothers of hospitalized breastfed young children appears to be suboptimal in Italian PUs. Interventions aimed to structure and improve the quality of breastfeeding support for the mother-child dyad are needed, particularly developing protocols and providing a training on breastfeeding to the majority of healthcare professionals.

Human milk oligosaccharides and the association with microbiota in colostrum: a pilot study

HMOs (Human milk oligosaccharide) has an impact on maternal and infant health. Colostrum samples of 70 breastfeeding women in China were collected and recorded clinical characteristics. The major oligosaccharides and microbiota were quantitated in colostrum. The concentration of fucosylated HMOs in primipara was higher than that of multipara (p = 0.030). The concentration of N-acetylated HMOs in vaginal delivery milk was less than that of cesarean (p = 0.038). Non-fucosylated HMOs of breastfeeding women were less than that of breast pump (p = 0.038). Meanwhile, the concentration of LNT was positively correlated with Lactobacillus (r = 0.250, p = 0.037). DS-LNT was negatively correlated with Staphylococcus (r = – 0.240, p = 0.045). There was a positive correlation of Streptococcus with LNFP II (r = 0.314, p = 0.011) and 3-SL (r = 0.322, p = 0.009). In addition, there was a negative correlation between 2'-FL and 3-FL (r = – 0.465, p = 0.001). There was a positive correlation between LNT and LNnT (r = 0.778, p = 0.001). Therefore, the concentration of HMOs is related to number of deliveries, delivery mode, lactation mode and perinatal antibiotic. The concentration of HMOs is related to Lactobacillus, Streptococcus and Streptococcus in colostrum. In addition, there are connections between different oligosaccharides in content. The study protocol was also registered in the ClinicalTrails.gov (ChiCTR2200064454) (Oct. 2022).

Lactating nurses' experiences of return to work after lifting COVID-19 lockdown: A qualitative study

AimTo explore the lactating nurses' experiences of return to work after lifting COVID-19 lockdown. BackgroundReturn to work is a key reason for the low rates of breastfeeding. Especially after lifting COVID-19 lockdown, case counts reached recorded highs. So lactating nurses face more challenges when they return to work. MethodThe empirical phenomenology method was used to conduct a qualitative study. Lactating nurses were recruited in a tertiary hospital through purposive and snowball sampling, and participated in semi-structured video interviews. Colaizzi's method was used to analyze the data. ResultsThree themes and 10 sub-themes emerged from the interview data of 15 participants. The first theme was “preparation for return to work”, which helped lactating nurses adapt to return to work quickly. The second was “experiences of return to work”. The inconvenience of pumping was mentioned repeatedly. In addition, the flexible work schedule was highlighted. The third was “experiences of infection”. The attitudes toward breastfeeding differed due to different perceptions of COVID-19. ConclusionsLactation nurses easily interrupted or stopped breastfeeding when they returned to work after lifting COVID-19 lockdown. Recommendations include the further provision of longer periods of leave, flexible working arrangements, separate facilities for breast pumping, and breastfeeding strategies for epidemics.

The relationship between creamatocrit and cumulative percentage of total milk volume: a cross-sectional study in mothers of very preterm infants in Bangkok, Thailand

BackgroundHuman hindmilk contains higher concentrations of fat than foremilk and is more desirable for growth in preterm infants who can tolerate limited volumes of breastmilk. There is currently no clear demarcation between foremilk and hindmilk. This study characterized the change in breastmilk’s fat content from the start to end of milk flow and defined this demarcation.MethodsMothers of infants born at ≤ 32 weeks gestational age and ≥ 14 days after childbirth in a University hospital in Bangkok, Thailand between July, 2011, and April, 2012 were included in this cross-sectional study. Breastmilk samples were sequentially collected from the start to end of milk flow in 5-mL aliquots using breast pumps. The fat content of each aliquot from each breast was determined through creamatocrit. The average creamatocrit of foremilk and hindmilk were compared in predefined foremilk to hindmilk ratios of 20:80, 25:75, 33:67, and 50:50. Creamatocrit of the first and last aliquots were compared for mothers who expressed low- (≤ 25-mL per breast) and high-volumes (> 25-mL per breast) of breastmilk.ResultsOf the 25 mothers enrolled, one was excluded due to unsuccessful creamatocrit measurement. The last aliquot of breastmilk had a significantly higher creamatocrit than the first from the same breast (median [interquartile range] of 12.7% [8.9%, 15.3%] vs. 5.6% [4.3%, 7.7%]; test statistic 1128, p < 0.001). Mean creamatocrit in hindmilk portions (9.23%, 9.35%, 9.81%, and 10.62%, respectively) was significantly higher than foremilk portions (6.28%, 6.33%, 6.72%, and 7.17%, respectively) at all predefined ratios. Creamatocrit increased by 1% for every 10% incremental increase in expressed breastmilk volume until the breast was emptied. Low-volume mothers had a significantly higher creamatocrit in the first aliquot compared with high-volume mothers (U = 437, p = 0.002). No significant difference in breastmilk volume was observed between mothers with and without breastfeeding experience.ConclusionsFat content in breastmilk increased on an incremental basis. More fluid definitions of foremilk and hindmilk should be adopted. Mothers should prepare their breastmilk into aliquots based on the required feeding volume of their infant. Hindmilk aliquots can be prioritized over foremilk aliquots to ensure infants obtain optimal caloric intake.

Detection of Clostridium perfringens in donor milk at a human breast milk bank: a case report

BackgroundThe breast milk bank is a professional organization that collects donor human milk (DHM) for special medical needs by recruiting qualified breast milk donors. Such organizations are also responsible for the disinfection, processing, testing, storage, distribution, and use of breast milk. As DHM is a biological product, it may get contaminated. Microbiological testing is the final step to determine microbial contamination of DHM. However, a universal method for the microbiological analysis of DHM in breast milk banks globally is lacking.DHM without strict screening may become a potential carrier of pathogens and seriously threaten the health of infants. Clostridium perfringens, a gram-positive anaerobic bacterium, is capable of causing wound infections, including gas gangrene, enteritis/enterocolitis, and enterotoxemia. Here, the first case of C. perfringens detected in DHM has been reported to facilitate the identification of such contamination in breast milk banks.Case presentationA breastfeeding mother donated 3000 mL of milk to the breast milk bank of the First Affiliated Hospital of the Army Medical University(over 2900 beds and patient receiving capacity of over 132,000), Chongqing, China. The milk sample was subjected to microbiological screening using liquid enrichment, followed by anaerobic and aerobic culturing. The results revealed the growth of C. perfringens in the anaerobic culture medium, but no bacteria or yeast-like fungi were observed in the aerobic culture medium. The donor did not exhibit any clinical symptoms, and her routine blood results and body temperature were normal. However, the infant fed with her milk had recurrent bloody stools. Breast milk bank infection control emergency handling as well as environmental sampling and investigation revealed that the cause was contamination of the donor’s home-use breast pump with C. perfringens. The infant no longer experienced bloody stool once the donor changed the breast pump.ConclusionsC. perfringens can enter breast milk from contaminated pumping environments or devices, thus causing illness in infants. The microbiological testing of DHM in breast milk banks can be accomplished using liquid enrichment, along with anaerobic and aerobic culture, which is of immense significance in improving the standards for microbiological screening, DHM safety, and infant health.