Human Milk Biomarkers of Secretory Activation in Breast Pump-Dependent Mothers of Premature Infants

Abstract

Secretory activation is delayed in mothers who deliver prematurely and is closely tied to CTV, MOM volume, and pumping frequency. MOM biomarkers hold promise as objective research outcome measures and for point-of-care testing to identify and proactively manage mothers at risk for compromised lactation.

Racial and socioeconomic disparities in breast milk feedings in US neonatal intensive care units

“…71,[73][74][75] Additionally, MOM synthesis and secretion may also be adversely affected by pregnancy and birth complications and the intense emotional distress associated with having a VLBW infant in the NICU. 73,[76][77][78][79] With recommendations from the American Academy of Pediatrics 80 and quality initiatives focused on MOM, [81][82][83] the initiation rates of MOM provision have increased in many institutions; 81,82 however, disparities in sustaining MOM provision remain. 29,84 Despite high initiation rates and a goal to continue MOM provision after NICU discharge, significantly fewer black VLBW infants continue to receive MOM at NICU discharge compared to non-black infants.…”

Delayed Lactogenesis II is Associated With Lower Sleep Efficiency and Greater Variation in Nightly Sleep Duration in the Third Trimester

“…Overall actigraphic sensitivity and accuracy are high relative to polysomnography, but specificity is low (Marino et al, 2013). Furthermore, although meta-analysis found the breast fullness survey adequate for determining the timing of lactogenesis II (Perez-Escamilla & Chapman, 2001), using a biomarker such as measuring milk and serum lactose or citrate levels, or weighing breasts (Murase, Wagner, J. Chantry, Dewey & Nommsen-Rivers, 2017; Panwara, Kasem, Wipada, Maysita & Pawin, 2016; Rebecca et al, 2018), would strengthen the approach to determining DLII. Moreover, data available from medical charts on labor length and the timing of first-feeding was sparse and varied by clinician.…”

25 Years of Research in Human Lactation: From Discovery to Translation

“…While long labours, caesarean section, and obesity have been associated with delayed SA [ 36 , 37 ] we found no evidence of delayed SA in women delivering by vaginal or caesarean section nor with analgesic administration during caesarean births [ 38 ]. Similarly, Cregan et al found no difference in concentration of milk citrate, lactose, protein, and sodium from mothers of term and preterm infants [ 39 ]. However, there was greater variation in these markers for preterm mothers and milk production was related to how many markers were in the normal range by Day 5 [ 39 ] in that women with fewer markers in the normal range had the lowest milk productions.…”

“…Similarly, Cregan et al found no difference in concentration of milk citrate, lactose, protein, and sodium from mothers of term and preterm infants [ 39 ]. However, there was greater variation in these markers for preterm mothers and milk production was related to how many markers were in the normal range by Day 5 [ 39 ] in that women with fewer markers in the normal range had the lowest milk productions. The significance of these data are that previously SA was considered a discrete event with failed SA attributed to either hormonal causes, e.g., no drop in progesterone due to retained placenta, or glandular causes, e.g., insufficient mammary tissue [ 40 ].…”