Validity of Hourly Breast Milk Expression in Estimating Maternal Milk Production and Infant Breast Milk Intake
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University of Cincinnati / OhioLINK
2019
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ndltd-OhioLink-oai-etd.ohiolink.edu-ucin15542113895102552021-08-03T07:09:47Z Validity of Hourly Breast Milk Expression in Estimating Maternal Milk Production and Infant Breast Milk Intake Roznowski, Dayna M. Nutrition human lactation milk production breastfeeding breast expression maternal milk supply infant weight gain Background: An efficient method for measuring milk production is needed to improve research evaluation and clinical management of early postpartum milk supply concerns.Objective: 1) Confirm steady state is reached by hour 2 of the Lai et al. hourly breast expression protocol, and externally validate milk production rate (MPR) can be estimated from the mean of hour 2 and hour 3 milk yield; 2) Determine if an increase in MPR is detectible following 48 hours of increased breast emptying; 3) Assess agreement between maternal milk production estimated by MPR compared to infant test-weighing, and 4) Characterize MPR mean and variance in a sample of mothers exclusively breastfeeding infants achieving appropriate weight gain.Design: Eligible mothers were 4-10 weeks postpartum and exclusively breastfeeding their term infants. In a research clinic, mothers emptied both breasts at baseline (h0), and hourly over 3 subsequent hours (h1, h2, h3) using a hospital-grade pump. We estimated mother’s steady-state MPR as mean (h2, h3). “Study A’ subset completed MPR measurements before and after 48 hours of increased breast emptying. “Study B” subset test-weighed their infant before and after breastfeeding for 48 hours (1-7 days before clinic visit). We used paired t-test for within-participant comparisons and used the Bland-Altman approach to compare 24-hour milk production (g/24h) measured using TW versus MPRx24h.Results: Among 23 mothers 54±14 days postpartum, milk output was 185±55, 60±26, 47±13, 44±13 g/h at h0, h1, h2, and h3, respectively. Mean paired difference (vs. h3) was significant at h0 and h1 (p<0.05), but not h2 (p>0.05, h3-h2=3±10 g/h). In Study A (n=5), mean MPR declined from 50±13 g/h to 43±16g/h (p=0.003) following increased breast emptying. In Study B (n=16), mean TW milk output=717±119 g/24h, and mean MPRx24h=1085±300 g/24h. Mean difference [95% limits of agreement] was 368 [±468] g/24h; and mean ratio was 1.5[±0.4]; difference and ratio significantly increased as MPR increased (p<0.05). For infants with adequate weight gain velocity of >20g/d (n=12) mean MPR was 48±12g/h, and ranged from 35 to 78 g/h.Conclusions: Hourly milk production reaches steady state at h2; thus MPR is a valid measure of current maternal milk production capacity but is not feasible for evaluating infant intake in early lactation. After 48 hours of increased breast emptying MPR declined, indicating a deeper level of hourly breast emptying may have been reached. An MPR =35g/h is consistent with successful exclusive breastfeeding in early lactation. 2019-07-25 English text University of Cincinnati / OhioLINK http://rave.ohiolink.edu/etdc/view?acc_num=ucin1554211389510255 http://rave.ohiolink.edu/etdc/view?acc_num=ucin1554211389510255 unrestricted This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws. |
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NDLTD |
| language |
English |
| sources |
NDLTD |
| topic |
Nutrition human lactation milk production breastfeeding breast expression maternal milk supply infant weight gain |
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Nutrition human lactation milk production breastfeeding breast expression maternal milk supply infant weight gain Roznowski, Dayna M. Validity of Hourly Breast Milk Expression in Estimating Maternal Milk Production and Infant Breast Milk Intake |
| author |
Roznowski, Dayna M. |
| author_facet |
Roznowski, Dayna M. |
| author_sort |
Roznowski, Dayna M. |
| title |
Validity of Hourly Breast Milk Expression in Estimating Maternal Milk Production and Infant Breast Milk Intake |
| title_short |
Validity of Hourly Breast Milk Expression in Estimating Maternal Milk Production and Infant Breast Milk Intake |
| title_full |
Validity of Hourly Breast Milk Expression in Estimating Maternal Milk Production and Infant Breast Milk Intake |
| title_fullStr |
Validity of Hourly Breast Milk Expression in Estimating Maternal Milk Production and Infant Breast Milk Intake |
| title_full_unstemmed |
Validity of Hourly Breast Milk Expression in Estimating Maternal Milk Production and Infant Breast Milk Intake |
| title_sort |
validity of hourly breast milk expression in estimating maternal milk production and infant breast milk intake |
| publisher |
University of Cincinnati / OhioLINK |
| publishDate |
2019 |
| url |
http://rave.ohiolink.edu/etdc/view?acc_num=ucin1554211389510255 |
| work_keys_str_mv |
AT roznowskidaynam validityofhourlybreastmilkexpressioninestimatingmaternalmilkproductionandinfantbreastmilkintake |
| _version_ |
1719455369365815296 |