The Utilization of Sodium Concentration in Human Milk from Pump-Dependent Mothers of Preterm Infants as a Measure of Milk Production

Yuan, S.Y.; Li, Qiufang; Wang, H; Xu, Xin

doi:10.1089/bfm.2022.0263

Cited by 3 publications

(4 citation statements)

References 28 publications

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“…6,24,25,27 Per study methods, these mothers were educated to pump every 2-3 hours, but results either fell short of this target or pumping behaviors were not reported. 12,25,27,28 In our study, mothers were educated to pump a minimum of 8 times daily, but our electronically-measured pumping data indicate that 12 of our 29 mothers fell into the LIPG, which on average pumped £4 times and <75 minutes daily. Even mothers in the HIPG did not achieve a mean of 8 pumping sessions daily.…”

Section: Pumping Behaviorsmentioning

confidence: 73%

“…MOM biomarkers of SA: Daily MOM samples (1.0 mL each) were collected on postpartum days 1-14 and stored at -20 0 C until Na and K concentrations were measured in duplicate using selective ion electrodes (Horiba; Japan), as described by this team and others. 4,6,[12][13][14] Na and K concentrations were measured in parts per million, then subsequently divided by the molecular weights for Na (22.9 g/mMol) and K (39.0 g/mMol).…”

Section: Methodsmentioning

confidence: 99%

“…8,24 Based on these studies, mothers of preterm NICU infants have been instructed to pump every 2-3 hours or 8-12 daily prior to achievement of SA. 1,4,6,12,25 However, we could not locate a study enrolling mothers of preterm NICU infants in which this target was actually achieved by more than a handful of outliers, 24,26 with most studies reporting an average of 4-5 daily pumping sessions during the early postpartum period. 6,24,25,27 Per study methods, these mothers were educated to pump every 2-3 hours, but results either fell short of this target or pumping behaviors were not reported.…”

Section: Pumping Behaviorsmentioning

confidence: 99%

“…5,8,24 Healthy, exclusively breastfed infants typically consume 500-600 mL of MOM by postpartum days 4-7. 20,21,33,34 Two randomized studies of breast pump-dependent mothers of preterm NICU infants reported similar mean volumes of pumped MOM 12,24 within the rst 7 postpartum days in mothers assigned to a speci c breast pump 12 or breast pump suction pattern. 24 Thus, rigorous research using accurate measures of pumping behaviors, pumped MOM volume, and achievement of SA and CTV should elucidate whether intense lactation care should target the rst 7 versus 14 postpartum days.…”

Section: Pumping Behaviorsmentioning

confidence: 99%

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Early Pumping Behaviors Predict Pumped Milk Volume, Achievement of Secretory Activation and Coming to Volume in Breast Pump-Dependent Mothers of Preterm Infants

Median-Poeliniz,

Hoban,

Signorile

et al. 2024

Preprint

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Objective: Pumping studies in mothers of preterm infants are limited by self-reported pumping behaviors and non-objective measures of pumped milk volume and secretory activation (SA). Study Design: Non-randomized observational study of first 14 days postpartum in 29 mothers of preterm infants. Smart pumps measured and stored pumping behaviors and pumped milk volume. Selective ion electrodes measured sodium and sodium:potassium ratio to determine SA. Generalized estimating equations, cluster analyses and multivariate regression were used. Results: SA was delayed (median 5.8 days) and impermanent. Each additional daily pumping increased odds of SA within 2 days by 48% (p=.01). High-intensity pumping mothers (N=17) had greater daily and cumulative pumped milk volume than low-intensity pumping mothers (N=12). Pumping variables showed daily changes in the first week, then plateaued. Conclusion: The first week postpartum is critical for optimizing pumping behaviors. Accurate, objective measures of pumping behaviors, pumped milk volume and SA are a research priority.

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Section: Pumping Behaviorsmentioning

confidence: 73%

Section: Methodsmentioning

confidence: 99%

Section: Pumping Behaviorsmentioning

confidence: 99%

Section: Pumping Behaviorsmentioning

confidence: 99%

See 2 more Smart Citations

Early Pumping Behaviors Predict Pumped Milk Volume, Achievement of Secretory Activation and Coming to Volume in Breast Pump-Dependent Mothers of Preterm Infants

Median-Poeliniz,

Hoban,

Signorile

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Early postpartum pumping behaviors, pumped milk volume, and achievement of secretory activation in breast pump-dependent mothers of preterm infants

Hoban,

Medina-Poeliniz,

Signorile

et al. 2024

J Perinatol

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Novel At-Home Mother’s Milk Conductivity Sensing Technology as an Identification System of Delay in Milk Secretory Activation Progress and Early Breastfeeding Problems: Feasibility Assessment

Haramati¹,

Firsow²,

Navarro³

et al. 2023

JMIR Pediatr Parent

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Background Prolonged exclusive breastfeeding is a public health priority and a personal desire by mothers; however, rates are low with milk supply challenges as a predominant cause. Early breastfeeding management at home is key. Milk electrolytes, mainly sodium ions, are accepted as biomarkers of secretory activation processes throughout the first weeks after birth and predictors for prolonged breastfeeding success, although they are not incorporated into routine care practice. Objective The aim of this study was to test the feasibility of a novel handheld smartphone-operated milk conductivity sensing system that was designed to compute a novel parameter, milk maturation percent (MM%), calculated from milk sample conductivity for tracking individual secretory activation progress in a real-world home setting. Methods System performance was initially evaluated in data collected from laboratory-based milk analysis, followed by a retrospective analysis of observational real-world data gathered with the system, on the spot in an at-home setting, implemented by lactation support providers or directly by mothers (N=592). Data collected included milk sample sensing data, baby age, and self-reported breastfeeding status and breastfeeding-related conditions. The data were retroactively classified in a day after birth–dependent manner. Results were compared between groups classified according to breastfeeding exclusivity and breastfeeding problems associated with ineffective breastfeeding and low milk supply. Results Laboratory analysis in a set of breast milk samples demonstrated a strong correlation between the system’s results and sodium ion levels. In the real-world data set, a total of 1511 milk sensing records were obtained on the spot with over 592 real-world mothers. Data gathered with the system revealed a typical time-dependent increase in the milk maturation parameter (MM%), characterized by an initial steep increase, followed by a moderate increase, and reaching a plateau during the first weeks postpartum. Additionally, MM% levels captured by the system were found to be sensitive to breastfeeding status classifications of exclusive breastfeeding and breastfeeding problems, manifested by differences in group means in the several-day range after birth, predominantly during the first weeks postpartum. Differences could also be demonstrated for the per-case time after birth–dependent progress in individual mothers. Conclusions This feasibility study demonstrates that the use of smart milk conductivity sensing technology can provide a robust, objective measure of individual breastfeeding efficiency, facilitating remote data collection within a home setting. This system holds considerable potential to augment both self-monitoring and remote breastfeeding management capabilities, as well as to refine clinical classifications. To further validate the clinical relevance and potential of this home milk monitoring tool, future controlled clinical studies are necessary, which will provide insights into its impact on user and care provider satisfaction and its potential to meet breastfeeding success goals.

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The Utilization of Sodium Concentration in Human Milk from Pump-Dependent Mothers of Preterm Infants as a Measure of Milk Production

Cited by 3 publications

References 28 publications

Early Pumping Behaviors Predict Pumped Milk Volume, Achievement of Secretory Activation and Coming to Volume in Breast Pump-Dependent Mothers of Preterm Infants

Early Pumping Behaviors Predict Pumped Milk Volume, Achievement of Secretory Activation and Coming to Volume in Breast Pump-Dependent Mothers of Preterm Infants

Early postpartum pumping behaviors, pumped milk volume, and achievement of secretory activation in breast pump-dependent mothers of preterm infants

Novel At-Home Mother’s Milk Conductivity Sensing Technology as an Identification System of Delay in Milk Secretory Activation Progress and Early Breastfeeding Problems: Feasibility Assessment

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