Combining hand techniques with electric pumping increases milk production in mothers of preterm infants

Abstract

Objective: Pump-dependent mothers of preterm infants commonly experience insufficient production. We observed additional milk could be expressed following pumping using hand techniques. We explored the effect on production of hand expression of colostrum and hands-on pumping (HOP) of mature milk.Study Design: A total of 67 mothers of infants <31 weeks gestation were enrolled and instructed on pumping, hand expression of colostrum and HOP. Expression records for 8 weeks and medical records were used to assess production variables.Result: Seventy-eight percent of the mothers completed the study. Mean daily volumes (MDV) rose to 820 ml per day by week 8 and 955 ml per day in mothers who hand expressed >5 per day in the first 3 days. Week 2 and/or week 8 MDV related to hand expression (P<0.005), maternal age, gestational age, pumping frequency, duration, longest interval between pumpings and HOP (P<0.003). Mothers taught HOP increased MDV (48%) despite pumping less. Conclusion:Mothers of preterm infants may avoid insufficient production by combining hand techniques with pumping.

Combining hand techniques with electric pumping increases the caloric content of milk in mothers of preterm infants

“…As described previously, of the 67 enrolled mothers, 52 remained in the study for the entire 8 weeks. 4 No significant demographic differences among the three groups were found.…”

“…By Week 8, mean production in all Groups was 658±267, 859±430, and 955±667 ml per day, respectively, as we have previously reported. 4 No statistical differences in mean pumping frequency in Groups I, II and III over the first 3 days postpartum or over days 1 to 14 were found.…”

“…We evaluated the values of fat, protein, lactose and energy in breastmilk over an 8-week study period from the three groups of mothers categorized by frequency of early hand expression: Group I (<2 times per day), Group II (2 to 5 times per day), and Group III (>5 times per day). Despite production differences between groups up to Week 8,4 there are no significant compositional or energy differences between groups after Week 1 (P ¼ 0.05).…”

“…The use of HOP did not increase pumping time and was associated with longer uninterrupted sleeping time. 4 This was the first report of mothers of preterm infants with a steady increase in production over 8 weeks, which surpassed reference levels for mothers of term infants. Recently, a pump with a newer suction pattern was shown to improve volume over earlier pumps, and yet subjects did not achieve production levels on a par with those we reported for mothers using frequent early hand expression.…”

“…4 Mothers who initiated expression by using frequent hand expression (>5  per day  3 days) produced the highest subsequent volumes. The influence of hand expression in the first 3 days was independent of pumping frequency and affected production up to Week 8.…”