The influence of early milk expression on production volumes in mothers of preterm infants 1 Yellayi ,
1 Maffei
Disha Christina Gomez-Juge, Victoria Silverman, Diana 1Donald and Barbara Zucker School of Medicine at Hofstra/Northwell
Background • Human milk is the ideal source of nutrition for preterm infants. • Previous studies have shown that there is a dose dependent relationship between Mother's own Milk (MOM) volumes and neonatal outcomes (1). • For many reasons, mothers who deliver prematurely often produce insufficient volumes of (MOM) (2). • Early initiation of first milk expression for mothers of preterm infants is critical to increasing overall milk supply. • There are established targets using a double electric breast pump for volume of milk pumped in order to reach full volume at Stage 2 lactogenesis (3-4). • Previous authors have only described time of initiation but not the frequency of early breast emptying (within the first week) on later milk production. • The goal of this study is to study the patterns of early expression of milk and the influence on later production.
Conclusions
Results
•There is a positive correlation between Day 7 milk volumes and Day 14 milk volumes, as well as between Day 21 and Day 28 •At this point there is not enough data collected to determine whether early initiation has an effect on later volumes •In collecting information about logging milk volumes, mothers seem to prefer to utilize paper logs. There have been difficulties with using the recommended app to collect logs which may change the standard practices in the NICU going forward if this trend continues.
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y = 0.6547x + 390.2 R² = 0.497
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Future Direction
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Hypothesis
Day 21 vs Day 28 Volume of Milk We hypothesize that the earlier and more frequently a mother of a preterm infant expresses milk, the greater milk production will be by day 28.
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• These data sets are preliminary. At the time of this data collection, we enrolled 20 mothers and plan to continue enrollment and complete analysis for those enrolled. • Based on the information obtained, we plan to optimize the methods for logging milk volumes and consulting mothers antenatally when possible. • We also plan on looking at correlations between number of times moms stimulates breast milk vs breast milk volumes
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Methods • Our study recruited mothers and their infants born <32 weeks and <1500 grams. • At the time of enrollment, based on the standard of care at CCMC and NS, mothers were encouraged to log information about pumping sessions (frequency and volume). • Follow up on the number of milk expressions as well as volumes at days 7, 14, 21 and day 28 were be collected.
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y = 1.083x + 0.893 R² = 0.9356
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Figure 7: Independent CRISPR knockout of CDK4 or CDK6 does not cause dropout in most breast cancer cell lines studied.
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Resources 1) Patel AL, Johnson TJ, Engstrom JL, et al. Impact of early human milk on sepsis and health-care costs in very low birth weight infants. J Perinatol. 2013;33(7):514-519. doi:10.1038/jp.2013.2 2) Parker, Leslie A., et al. “Timing of Milk Expression Following Delivery in Mothers Delivering Preterm Very Low Birth Weight Infants: A Randomized Trial.” Journal of Perinatology, no. 8, 2020, p. 1236. EBSCOhost, doi:10.1038/s41372020-0688-z. 3. Parker L, Sullivan S. Krueger C. et al., Association of timing of initiation of breastmilk expression on milk volume and timing of lactogenesis State II among mothers of very low-birth-weight infants. 2015. 10 (2) 84-91. 4. Lussier M. Brownell E, Proulx T. Daily breastmilk volume in mothers of very low birth weight neonates: A repeated measures randomized trial of hand expression versus electric breast pump expression. 2015. Breastfeeding Medicine. 10 (6) 312-317.