Short-term rate of milk synthesis and expression interval of preterm mothers. Issue 3 (11th July 2019)

• Record Type: Journal Article
• Authors: Lai, Ching Tat; Rea, Alethea; Mitoulas, Leon R; Kent, Jacqueline C; Simmer, Karen; Hartmann, Peter Edwin; Geddes, Donna
• Is Part Of: Archives of disease in childhood. Volume 105:Issue 3(2020)
• Page Start: 266
• Page End: 269
• Publication Date: 2019-07-11
• Subjects: preterm -- milk production -- breast expression -- pumping regime; Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2018-316551
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Aim: To determine the impact of the pumping regimes of women with preterm infants on the daily milk production, and on the short-term rate of milk synthesis during early lactation to support evidence-based recommendations for optimising milk production. Methods: Mothers of preterm infants (n=25) recorded start time, finish time and expression volumes from every breast expression on days 10, 15–20 postpartum. Results: Expressing more often than five times per day did not result in a significant increase in daily milk production. Milk volume per expression per breast increased for intervals between expressions of between 2and6 hours then reached a plateau when the interval between expression was 7 hours or longer. The short-term rate of milk synthesis decreased as the interval between expressions increased until about 7.5 hours at which point it begun to increase (p value associated with interval between expressions^2<0.001). Conclusion: The strong inverse association between the short-term rate of milk synthesis and the interval between expressions for intervals up to 7 hours suggest that the maximum interval between expressions should be 7 hours. Data suggest that, on average, the mothers should express at least five times a day to maximise daily milk production. Considering inter-individual variation, determination of an individual mother's maximum interval between expressions that does not compromise the short-term rate of milk synthesis will help to optimise daily milk production while minimising the demands on the mother's time.