Initiation Of Milk Expression Research Articles

Predictors of the Provision of Mother's Milk Feedings in Newborns Admitted to the Neonatal Intensive Care Unit.

Background: Breast milk reduces morbidity and mortality in infants admitted to neonatal intensive care unit (NICU). Objectives: We determined predictors of procuring mother's own milk (MOM) among NICU-admitted newborn-mother dyads: (1) initiation of any milk expression; (2) initiation of milk expression within 6 hours of birth; (3) MOM as the first enteral feeding; (4) colostrum for oral care within 36 hours of birth if not yet orally fed; and (5) provision of MOM at 21 days of life or discharge, whichever occurred first. Methods: We performed a retrospective chart review of NICU-admitted newborn-mother dyads at an urban medical center from June 1, 2018-May 31, 2019. We excluded infants not directly admitted to the NICU, those never enterally fed, multiple gestations if not the first to be discharged, and infants discharged to a nonbiological caregiver. We used chi-square analysis to examine unadjusted associations between independent variables and MOM outcomes and then used logistic regression to determine the adjusted odds ratio and 95% confidence interval (AOR [95% CI]) for predictors of MOM outcomes. Results: There were 341 mother-infant dyads who met inclusion criteria and 71% of these mothers initiated milk expression. Smoking, multiparity, gestational diabetes, and Hepatitis C lowered the odds for at least one MOM outcome; whereas mothers who delivered at 28-32 weeks versus ≥33 weeks, and infants with birthweight <1,500 g versus 1,500-2,500 g had higher odds for at least one MOM outcome. Conclusion: Maternal/infant dyad characteristics may predict some, but not all NICU breastfeeding outcomes. This suggests that hospital practices may influence these outcomes and can inform future interventions.

Breast Milk Expression and Maintenance in Mothers of Very Low Birth Weight Infants: Supports and Barriers

The study objective was to identify patterns of factors that supported or hindered initiation of breast milk expression and maintenance of breast milk production after the birth of a very low birth weight (VLBW) infant in a sample of US women with varied prenatal infant feeding intentions. In-depth interviews were conducted 1 to 6 months after delivery in 32 women who initiated breast milk expression after encouragement from hospital staff. Pregnancy complications, anxiety regarding their infant's health, and lack of privacy interfered with initiation of milk expression. After hospital discharge, using manual or small electric breast pumps, travel to the neonatal intensive care unit, return to work, and difficulty with time management interfered with maintenance of breast milk production. Family support, positive attitudes toward pumping, and anticipation of breastfeeding supported maintenance of breast milk production. From these data emerge points of intervention where additional support could improve mothers' experiences and increase duration of breast milk feeding.

Milk Production by Mothers of Premature Infants

Milk volume, day of initiation of pumping, duration and frequency of milk expression, and length of night rest interval were evaluated for the first month postpartum in 32 healthy, nonsmoking women (ages 20 to 38 years) who delivered at 28 to 30 weeks' gestation. Early milk volumes were related negatively to the delay between delivery and the initiation of milk expression (r = -.48, P less than .02). Average milk volumes at 2 weeks and 4 weeks postpartum were 493 +/- 330 and 606 +/- 369 mL/d (mean +/- SD), respectively, and were not related to the absolute frequency or duration of pumping or to night rest interval. Volume changes between weeks 2 and 4 postpartum were correlated with the absolute frequency (r = .49, P less than .01) and duration of pump use (r = .42, P less than .05) during this interval and with changes in frequency (r = 0.56, P less than .002) or duration (r = 0.49, P less than .05) between the first 2 and the second 2 weeks postpartum. Optimal milk production was associated with five or more milk expressions per day and pumping durations that exceeded 100 min/d.