Validity of a 3-Hour Breast Milk Expression Protocol in Estimating Current Maternal Milk Production Capacity and Infant Breast Milk Intake in Exclusively Breastfeeding Dyads

Abstract

Objective: An efficient method for measuring maternal milk production is needed. Our objectives were to: (1) validate a milk production rate (MPR) protocol in exclusively breastfeeding mothers; (2) determine MPR change following 48 hours of increased breast emptying; (3) assess agreement between MPR and infant testweighing; and (4) characterize MPR in early postpartum exclusively breastfeeding mothers. Materials and Methods: N = 23 mothers emptied both breasts hourly over 3 hours (h0, h1, h2, and h3). We estimated steady-state MPR as mean (h2 and h3). Subset A mothers (n = 5) also completed MPR measurements after 48 hours of increased breast emptying. Subset B mothers (n = 16) also test-weighed for 48 hours. We used paired t-test to examine within-participant change in hourly milk yield and MPR; and we used Bland-Altman analysis to compare 24-hour milk production (g/24 hours) measured using test-weight versus MPR. Results are reported as meanstandard deviation or (-95% limits of agreement). Results: Mothers were 54 -14 days postpartum. Paired difference in h3-h2 hourly milk yield was not significantly different ( p > 0.05, 3 -10 g/hour). In Subset A (n = 5), MPR declined from 50 -13 to 43 -16 g/hour ( p = 0.003) following 48 hours of increased breast emptying. In Study B (n = 16), mean infant test-weighed intake (TW) was 717 -119 g/24 hours, and mean MPR was 1,085 -300 g/24 hours. Mean difference (MPR-test-weigh) and mean ratio (MPR/test-weigh) significantly increased as MPR increased ( p < 0.05). For infants with adequate weight gain (>20 g/24 hours, n = 12), mean MPR = 48 -12 g/hour (range, 35-78 g/hour). Conclusion: MPR is a valid measure of current maternal milk production capacity, but is not accurate for evaluating infant intake in exclusively breastfeeding dyads.

Measures of Maternal Metabolic Health as Predictors of Severely Low Milk Production

“…Evaluation of the latter cases by the study lactation consultant identified inadequate or irregular feeding frequency and poor milk transfer at the breast. 25 Thus, 12 participants with complete test-weighs and who were exclusively breastfeeding infants with healthy rates of weight gain comprised the external control group. Their infants' breast milk intake ranged from 661 to 915 mL/24 hours at 28–65 days of age.…”

“…From March through June of 2018, we recruited exclusively breastfeeding mothers for a study of hourly milk production rate 25 through communication with in-person parent support groups and parenting social media sites. We screened potential participants through telephone for these inclusion criteria: 4–10 weeks postpartum at time of screening (to capture a postpartum timeframe comparable with the pilot RCT follow-up measurements), mother ≥20 years of age, and currently exclusively breastfeeding a healthy singleton infant born at ≥37 weeks gestation; and these relevant exclusion criteria: living outside the catchment area, history of breast surgery, current maternal diagnosis of type 1 or type 2 diabetes, evidence of insufficient infant weight gain based on maternal report of infant weight history, 26 or tandem breastfeeding.…”

The effect of multi-dimensional postpartum visits on increasing the breastfeeding rate of parturients with inverted nipple: a randomised study

“…This measure not only provides traditional in-person health education to parturients, but also implements online visits through the establishment of a network platform to overcome the limitations of time and space, allowing parturients to consult with medical staff who can provide professional advice anytime and anywhere after discharge from the hospital (12,13). Intervention staff is also able to regularly provide breastfeeding and nipple depression related information to parturients via the WeChat platform, so as to effectively correct previous misconceptions and improve breastfeeding awareness (14).…”

Factors Related to Colostrum Feeding of Postpartum Mother at Public Health Center in Kudus

“…The magnitude of the role of the family, especially the husband in providing support and motivation to his wife to give colostrum, determines the success of exclusive breastfeeding. (Roznowski et al, 2020) Many things affect the husband's low support for his wife in giving colostrum. One of these factors is that traditional family patterns still color people's lives.…”