Perception Of Milk Supply Research Articles

Use of Galactagogues in a Multi-Ethnic Community in Southeast Asia: A Descriptive Study.

PurposeGalactagogues are substances that increase breast-milk production. They can be medication, herbs or food. Use of galactagogues may be different among the major ethnic groups in Malaysia. The primary objective of this cross-sectional study is to determine the prevalence of galactagogues use among breastfeeding mothers in a multi-ethnic community.Patients and MethodsSelf-administered questionnaires were distributed between November 2016 and January 2017 to mothers attending the health clinics and private hospital paediatric clinics in Penang, Malaysia, whose infants were below 6 months of age. The questionnaire enquired about use of galactagogues, types of galactagogue used, perceived effectiveness and sources of information. It also asked mothers about what they would do to increase milk supply.ResultsWe analyzed 322 out of 530 questionnaires distributed where 76% of mothers reported use of galactagogues; most of which were food-based: dates (66%), oats (58%) and soya bean (56%). Each major ethnic group had a different preference for galactagogues: Malays (dates), Chinese (soya bean) and Indians (oats). Only one mother used pharmacological galactagogues alone. Galactagogues were perceived to be effective by 65% of mothers who used them. Multivariate analysis showed that use of galactagogues was not related to ethnicity, education, work, perception of milk supply or use of formula milk. The most common source of information on galactagogues came from family and friends.ConclusionUse of galactagogues is common in our population, especially food-based ones, and the choice of galactagogues differs by ethnicity. Future studies on efficacy and safety galactagogues should be focused these commonly used ones. There is also a need for qualitative studies to improve our understanding of why they are widely used in this region.

Exclusive breastfeeding, breastfeeding self-efficacy and perception of milk supply among mothers in Singapore: A longitudinal study

AimThis study aimed to examine the factors that affect exclusive breastfeeding among mothers in Singapore. Design & ParticipantsThis was a longitudinal study over 6 months. Data was collected on 400 mothers with breastfed infants who attended at primary care clinics. MethodMothers completed self-administered questionnaires on breastfeeding practices, demographic factors, breastfeeding self-efficacy and perception of milk supply at three time points: baseline and follow up visits at infant age 3 months and 6 months. The tools used were the Breastfeeding Self-Efficacy Scale (Short form) (BSES-SF) and Perception of Insufficient Milk (PIM) questionnaire. FindingsExclusive breastfeeding rate was 38.2% at infant age 6 months. Baseline breastfeeding self-efficacy and perception of milk supply scores were significantly higher for mothers who continued exclusive breastfeeding up to 6 months compared to those who had stopped exclusive breastfeeding (p < .01). Generalized Estimating Equation model (GEE) showed that mothers who had tertiary education (OR 2.65, 95% CI 1.24–5.66), planned to breastfeed for at least 6 months (OR 6.81, 95% CI 2.15–21.57), had baseline BSES-SF above 50 (OR 1.95, 95% CI 1.07–3.54) and PIM scores above 20 (OR 4.05, 95% CI 2.35–6.97) were significantly more likely to be exclusively breastfeeding at 6 months.

Are Prolactin Levels Linked to Suction Pressure?

Suction pressure has been reported to be a key driving force of lactation. An infant's sucking at its mother's breasts is the major stimulus to post-natal prolactin (PRL) secretion, and PRL is the essential hormone for lactation and milk production. It is unknown what role suction pressure has in PRL secretion and milk supply postnatally. To explore the relationship between the suction pressure, PRL level, lactation, and milk supply in breastfeeding mother-infant dyads. Healthy women with normal full-term infants were enrolled (n = 122). Data collection included suction pressure, PRL level, and the mother's perception of both the onset of her lactation and her milk supply at 1 month. Suction pressure was measured with a pressure sensor connected to a tube placed alongside the nipple. The chemiluminescence method was used to quantify maternal serum PRL level both before and after a breastfeed to explore the effect of suckling on PRL increment. The mother's perception of the onset of her lactation was evaluated by the mother's sense of fullness in her breast. The mother's perception of milk supply was evaluated by using the H&H Lactation Scale. Data from 117 participants were included in this analysis. Low suction pressure, a shorter gestational age, a high pre-gestational body mass index (BMI), and high infant birth weight were associated with a smaller than average PRL increment. High suction pressure, longer sucking duration, and a low gestational weight gain were related to a mother's perception of an earlier onset of her lactation. However, low suction pressure, a high frequency of giving formula, a small PRL increment, and the mother's perception of a later onset of her lactation were correlated with her perception of an insufficient milk supply. Suction pressure varied directly with the post-natal PRL increment. Suction pressure was associated with the timing of the mother's perception of her lactation. Strong suction pressure by the infant is likely to enhance the mother's confidence in her lactation. Additionally, sucking duration, frequency of giving formula, maternal BMI, and infant birth weight played a role in early breastfeeding success.

Impact of Measuring Milk Production by Test Weighing on Breastfeeding Confidence in Mothers of Term Infants.

The duration of exclusive breastfeeding is affected by maternal confidence and perception of milk supply, but objective measurement of milk supply is rarely used. Mothers of preterm infants have found measuring milk supply by in-home test weighing to be helpful to ascertain their infants' breastfeeding intake. This study aimed to determine if this technique affects breastfeeding confidence of mothers of term infants. Participants filled in a survey of their breastfeeding confidence and perceptions of breastfeeding behavior prior to and after a 24-hour period of recording the times of feeds, amounts of each breastfeed or bottle feed (expressed breastmilk or formula), and amounts of breastmilk expressed. The breastfeeding confidence of at least 66% of mothers who were initially confident was maintained, and the breastfeeding confidence of at least 11% of mothers who were initially not confident was improved after objective measurement of milk supply and breastfeeding behavior. Measurement of actual milk supply and breastfeeding behavior provides objective information that can guide clinicians in the management of lactation. It can also help to maintain or improve breastfeeding confidence.

Clinical Application of Measurement of Breastmilk

We aimed to assess whether measurement of 24‐h milk production (MP) affects breastfeeding (BF) confidence, which may in turn affect BF exclusivity and duration.Mothers (n=105) reported their BF confidence and perception of milk supply before and after measuring MP by test‐weighing (BabyWeigh scales, Medela AG) and being advised of the normal range of MP (478–1298g). A second measurement of MP was done 3.7 ± 2.9 weeks later in a self‐selected sub‐group (n=19, MP 237–863g) after advice from a lactation consultant.Of 76 mothers initially confident in their BF, only 4 lost confidence, and these 4 had MP&lt;700g. Of 29 mothers initially not confident in their BF, 18 gained confidence. Of the 11 still not confident, 6 had MP&lt;700g. BF confidence was not related to actual MP either before (P=0.787) or after (P=0.236) measurement of MP.Mothers who initially perceived that their milk supply was normal gained confidence in their BF after measurement (P=0.009). Mothers who perceived that their milk supply was low had no change in BF confidence before and after measurement (P=0.658).Mothers who repeated measurement of MP showed an increase of 154±128g (P=0.013). The majority (n=11) remained confident throughout, and 7 gained confidence.We conclude that BF confidence is improved by measuring MP when MP is &gt;700g. Moreover, measurement can quantitate improvement in MP.Research support was an unrestriced grant from Medela AG.