Effect of pumping pressure on onset of lactation after caesarean section: A randomized controlled study

Abstract

Caesarean section is associated with weaker newborn suction pressure. This nonblinded, randomized trial explored the effect of suction pressures generating by a breast pump on mothers' onset of lactation and milk supply after caesarean section. A high pressure group (−150 mmHg), a low pressure group (−100 mmHg), and a control group (none) were generated under computer random assignment with concealed allocation in 2 tertiary hospitals. The breast pumping began within 2 hr after caesarean operation (6 times a day and 30 min per time) until onset of lactation.The primary outcomes were the timing of onset of lactation, milk supply, and mother's satisfaction in lactation, using both intention-to-treat and per-protocol analyses. The secondary endpoints were the pumping-related pain, nipple injury, and maternal fatigue. All 164 women randomized were included in analysis. The breast pumping at −150 mmHg optimally advanced the timing of the onset of lactation and increased daytime milk supply. The pumping also appeared to boost mothers' confidence in lactation. The results in the per-protocol population (n = 148) were consistent with those of intention-to-treat population (n = 164). However, the pumping aggravated maternal nipple pain and fatigue, though there was no statistical significance.The findings suggest that a higher pumping pressure within the range of normal vaginally born infant suction could promote onset of lactation and milk supply among mothers giving birth by caesarean section. The pumping could also enhance mothers' confidence in breastfeeding.

Caesarean section and lactation problems in women

“…Торможение наступления второй стадии лактогенеза [19] Низкий сосательный рефлекс у детей, рожденных путем кесарева сечения Удлинение срока становления лактационной функции и сокращение длительности лактации [32] Известно, что для младенца запах околоплодных вод и запах молозива идентичны. Поэтому прикладывание малыша к груди матери на родовом столе необходимо не только с физиологической, но и с психологической точки зрения Оно особенно важно при ослабленном сосании младенца или невозможности совместного пребывания в палате матери и ребенка, особенно в группах риска [37].…”

The Effect of Oketani Breast Massage on Successful Breastfeeding, Mothers’ Breastfeeding Support Need, and Breastfeeding Self-Efficacy: A Clinical Trial Study

“…Since the most important factor for the survival and health of infants is breastfeeding, and the first environment to start breastfeeding is the hospital environment (20,21). Given the importance of the role played by nurses in supporting, educating, and promoting breastfeeding.…”

“…Given the importance of the role played by nurses in supporting, educating, and promoting breastfeeding. considering that Oketani massage is a low-cost, independent nursing intervention; and finally, concerning the breastfeeding problems faced by cesarean section mothers (8,21,46), the present study explored the effect of Oketani breast massage on the need for support during breastfeeding, breastfeeding success, and breastfeeding self-efficacy among mothers undergoing caesarian section.…”

Effects of three methods of breast milk expression on breastfeeding initiation, breast milk extraction and proportion of exclusive breastfeeding—an open label, randomized controlled trial

“…[22][23][24] Second, mothers who deliver by cesarean section are usually prevented from putting their infants to breast <1 hr after birth, and hence have a delay in lactation initiation and reduced lactation duration. [25][26][27][28][29][30][31][32][33] In view of the high annual Cesarean delivery rates reported in mainland of China, raised from 28.8% in 2008 to 34.9% in 2014, 34 together with the short period (14 weeks) of paid maternal leave, 35 the prevalence of breast pumping expression would be expected to be high in China. For mothers of established breastfeeding it was believed that the excessive breast milk after direct breastfeeding should be removed and the breast milk should be expressed regularly in absence of direct breastfeeding in order to stimulate the breast milk production.…”

“…For mothers of established breastfeeding it was believed that the excessive breast milk after direct breastfeeding should be removed and the breast milk should be expressed regularly in absence of direct breastfeeding in order to stimulate the breast milk production. 19,27,[36][37][38] As a result, the breast expressing was recommended to nursing mothers in absence of infant suction after birth or after established lactation in context-speci c manner.…”