Early pumping frequency and coming to volume for mother’s own milk feeding in hospitalized infants

A Cohort Study on Comparison of Volumes of Breast-Pump-Expressed Human Milk Donor Among Term and Preterm Gestational Mothers in South India––Time to Redefine “Coming to Volume” in the Milk Bank?

“…The same definition for "Coming to Volume" has been used in two other studies. 8,9 However, similar literature from India could not be found to the best of our knowledge. Considering the voluntary donation of mothers in the present cohort, a volume of 80 mL per sitting was assumed to define "Coming-to-Volume".…”

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

“…Outcomes included average daily number of pumping sessions (i.e., frequency) by WOL, average daily time spent pumping (i.e., duration) by WOL, and other pumping behaviors, including the percent of days with at least 5 pumping sessions by WOL and percent of days with an early morning pumping session by WOL ( 43 ). For each WOL, average daily number of pumping sessions per week was calculated as Average daily time spent pumping was calculated as for each week where i = day and n = number of days in a week.…”

“…These include preterm delivery, maternal illnesses such as preeclampsia, increased rates of cesarean delivery, stress of the NICU hospitalization, separation from their infant, and reliance on a breast pump to initiate and sustain MOM provision ( 38 ). Several studies have demonstrated the importance of pumping behaviors (e.g., daily minutes spent pumping, daily number of pumping sessions, inter-pump intervals) on establishing and sustaining MOM provision during the NICU hospitalization, including initiating milk expression within the first 6 h after birth ( 39 – 42 ), pumping during the early morning ( 43 ), and adequate pumping frequency, especially in the first 4–14 days postpartum ( 35 , 39 – 45 ). Stimulation of the mammary gland by the infant or breast pump during the transition from secretory differentiation to secretory activation is critical, with programming effects on lactocytes ( 38 , 39 , 46 ).…”

“…Recommendations for pump-dependent women include pumping 8–12 times daily, especially in the first 14 days postpartum ( 47 , 48 ). Furthermore, studies suggest a minimum of 5–6 pumping sessions per day during the first 1–3 weeks postpartum is associated with establishing appropriate MOM volume, called coming to volume (CTV, pumping ≥500 mL/day MOM) by 14 days postpartum, or continued MOM provision to NICU discharge ( 35 , 40 , 41 , 43 , 49 ). A study of 415 mothers of VPT infants from 2008 to 2012 indicated that CTV was the most significant predictor of MOM provision at NICU discharge (odds ratio [OR] 7.46, 95% confidence interval [CI] 3.26 to 17.07, p < 0.001) ( 35 ).…”

“…To date, few studies have examined how frequently and when mothers of VPT infants actually pump and how pumping behaviors vary by maternal and infant characteristics ( 35 , 39 – 41 , 43 , 49 , 50 ). The aims of this study were to (1) examine the variation in pumping behaviors (i.e., average daily time spent pumping, average daily number of pumping sessions, percent of days with an early morning pumping session [between 1:00 a.m. and 4:59 a.m. ( 43 )], and percent of days with at least 5 pumping sessions) by postpartum week, and (2) provide a descriptive comparison of pumping behaviors by maternal and infant characteristics, including maternal race/ethnicity, age at birth, and primary payment source and infant gestational age (GA).…”