Breastfeeding Medicine最新文献

Objective: To determine if cumulative measures of pumping behaviors over the first 5 days postpartum predicted lactation outcomes by postpartum days 7 (achievement of secretory activation [SA] and pumped milk volume) and 14 (achievement of coming to volume [CTV ≥500 mL of pumped milk]) in breast pump-dependent mothers. Methods: This observational study had usable data for 29 mothers. Predictor and outcome variables were measured via Smart Pump technology (Medela, AG). Pumping behaviors were measured electronically. SA was measured using mothers' own milk (MOM) sodium (Na ≤16 Mmol). Pumped MOM volume was measured to the nearest 0.1 g. Cumulative pumping behaviors were calculated from birth to postpartum day 5. Breast pump use was standardized during two pumping sessions. Results: In this diverse sample (48% Black, 34% Hispanic, 18% other), each additional 1-hour spent pumping between postpartum days 1-5 increased odds of achieving SA by day 7 by 2.8 (p = 0.01) and translated into an additional 1,278 mL of pumped MOM volume. Each additional inter-pump interval >5 hours between birth and postpartum day 5 was associated with a decrease of 242 mL of pumped MOM volume by postpartum day 7 (p = NS). Achievement of CTV by day 14 was not significantly related to pumping behaviors during the first 5 days postpartum. Conclusions: The first 5 days postpartum are a critical window when breast pump use significantly affects achievement of SA and pumped MOM volume. The lack of effect on later CTV achievement suggests that effective breast pump use is essential to transition to the autocrine/paracrine control of lactation.

Objectives: Describe pumping behaviors and pumped mother's own milk (MOM) volume by achievement of secretory activation (SA; MOM sodium [Na] concentration ≤16 mM), coming to volume (CTV; ≥500 mL pumped MOM/day), SA maintenance (continued daily Na ≤16 mM), and opportunity costs in the first 14 postpartum days for pump-dependent mothers of preterm infants in the neonatal intensive care unit. Methods: A secondary analysis of two prospective cohorts. Mothers recorded pumping and MOM volume for each pumping session during the first 14 postpartum days. Daily MOM Na concentration was measured to determine SA. The opportunity cost was the dollar value of time spent pumping. Regression models evaluated pumping behaviors, pumped MOM volume, and opportunity cost by SA and CTV achievement and SA maintenance. Results: Of 66 mothers, 94% and 41% achieved SA and CTV, respectively, and 44% of mothers who achieved SA maintained it through 14 days postpartum. Mothers who achieved SA had more pumping sessions (5.6 versus 4.3/day, p < 0.001), longer pumping duration (108 versus 83 minutes/day, p < 0.001), and higher pumped MOM volume (349 versus 218 mL/day, p < 0.001). Mothers who achieved versus did not achieve CTV pumped 5.6 versus 4.9 times/day (p = 0.050). Opportunity costs were $376 for mothers achieving SA, $155 higher than not achieving, and $441 for mothers maintaining SA, $94 higher than not maintaining SA. Conclusion: Pumped MOM volume and opportunity costs were higher for mothers who achieved and maintained SA. Strategies offsetting opportunity costs during the stressful early postpartum period for breast pump-dependent mothers of preterm infants are needed.

Introduction: Donor human milk (DHM) is the next best option when mothers' milk is unavailable. The study objective was to examine mothers' knowledge and attitudes regarding DHM. Materials and Methods: A prospective, descriptive, online study using mixed methods. Regression analysis was used to control for confounding variables and content analysis for the qualitative component. Results: Eighty mothers from the Palestinian Territories and Israel participated. Mothers' mean objective knowledge score was 3.4/6, and self-evaluation knowledge score was 2.4/5, with religion significant for both scores (p < 0.001 and p = 0.002), respectively. Compared with Muslim mothers, Christian and Jewish mothers were more likely to prefer DHM to formula: (adjusted odds ratio [95% confidence interval], 4.9 [1.5-16.6], and 17.5 [4.3-71.4]), donate HM (human milk) to a friend or relative (7.8 [2.0-30.3]) and 60 [9.9-362.3]) or donate HM to a human milk bank (5.4 [1.3-23.3] and 11.2 [2.6-47.5]). Muslim and Christian mothers were more likely to state that DHM was permissible only under certain circumstances. Regression analysis revealed that only religion was significant for mothers' response that DHM was permissible (p < 0.001). Qualitative analysis revealed that differences in mothers' knowledge and attitudes were related to milk kinship. Conclusions: In this first study of mothers' knowledge and attitudes of DHM in the Palestinian Territories and Israel, results revealed low knowledge and negative attitudes regarding DHM correlated with the mother's culture. Future programs should include culturally competent initiatives regarding the benefits of DHM.

Objective: The aim of this study is to examine the effects of breast massage and warm compression on milk secretion and anxiety in the mothers of premature newborns. Methods: In this randomized controlled trial, 120 mothers of premature newborns in the neonatal intensive care unit (NICU) were assigned to three intervention groups (massage, n = 30; warm compression, n = 30; massage-warm, n = 30) and one control group (n = 30). Mothers in the massage group performed massage, those in the warm compression group applied compresses, and the combined group used both methods, whereas the control group used a breast pump with no intervention. Milk production was measured in milliliters (mL) after each pumping session over 4 days, and anxiety levels were assessed at baseline and on the 4th day. Results: Mothers with premature newborns in the NICU had mean breast milk amounts of 1,321.43 ± 569.01 mL in the massage group, 1,470 ± 718.93 mL in the warm compression group, 1,484.23 ± 889.28 mL in the massage-warm group, and 913.75 ± 679.90 mL in the control group. The massage, warm compression, and massage-warm groups had significantly higher milk production than the control group (p < 0.05). In addition, anxiety levels in the intervention groups significantly decreased compared with the control group (p < 0.05). Mothers reported satisfaction with all interventions, with no significant differences between the groups (p > 0.05). Conclusion: Breast massage, warm compression, and breast massage-warm compression can be suggested as effective, simple, and cost-effective methods for increasing milk quantity and decreasing maternal anxiety.

Introduction: In recent years, foot reflexology has been frequently used as a method to solve problems such as stress, pain, and depression. It has been observed that the studies focused on the effect of foot reflexology on the pregnancy and birth process. Research Aim: A meta-analysis of experimental trials evaluating the effectiveness of foot reflexology applied in the postpartum period on comfort and breastfeeding outcomes was conducted in the present study. Materials and Methods: A comprehensive electronic search was done through the PubMed, WoS, Wiley, ScienceDirect, Scopus, and Google Scholar databases to identify experimental articles. There was no time restriction when searching the database. The risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist for quasi-experimental studies and the Cochrane risk of bias tool for randomized trials. The meta-analysis was conducted using Comprehensive Meta-Analysis. Cochran's Q test and Higgins' I² were used to assess study heterogeneity. Results: Three studies, two randomized controlled trials and one quasi-experimental trial (n = 260), were included in the analysis. Foot reflexology applied to postpartum women was found to have positive effects on the LATCH (standardized mean difference [SMD]: 1.010, confidence interval [CI]: 0.752/1.269, Z = 7.664, p = 0.000), Visual Analogue Scale (VAS)-breast tension (SMD: 2.212, CI: 1.902/2.522, Z = 13.981, p = 0.000), VAS-breast heat (SMD: 2.240, CI: 1.928/2.552, Z = 14.086, p = 0.000), VAS-breast pain (SMD: 2.302, CI: 1.836/2.768, Z = 9.686, p = 0.000), postpartum comfort (SMD: 3.578, CI: 3.131/4.025, Z = 15.689, p = 0.000), and breastfeeding satisfaction (SMD: 1.492, CI: 1.178/1.806, Z = 9.318, p = 0.000) scores. Conclusions: This meta-analysis determined that the foot reflexology intervention increased breastfeeding success, satisfaction, and postpartum comfort levels and statistically significantly reduced the signs of breastfeeding onset.

Purpose: Postpartum depression (PPD) resembles a major depression in the postpartum period and affects 10-15% of all women after giving birth. Several studies suggest an association between a lower risk of PPD and breastfeeding. The highly stressful period of the COVID-19 pandemic has led to an increase in the incidence of mental illness in general and PPD in particular. Our aim was to investigate the relationship between breastfeeding behavior and PPD in more detail. Methods: In this context, 291 women who gave birth between April 2020 and September 2021 were surveyed up to 6 months postpartum on depressive symptoms, breastfeeding behavior, and anxieties. Results: In particular, the fact that the women stated after 6 months that their expectations of breastfeeding had been met appeared to lead to a significantly lower risk of PPD. Therefore, not breastfeeding frequency but satisfaction with breastfeeding behavior was decisive for the risk of PPD development. Significant correlations were found between different anxieties and breastfeeding behavior. Higher anxieties led to a shorter desired time of breastfeeding in months, less frequent breastfeeding per day, and less satisfaction with breastfeeding behavior. Conclusion: Our results suggest that improving the breastfeeding experience as well as reducing prepartum anxieties or treating postpartum anxieties could be a primary prevention for PPD.

Background: Use of marijuana and its derivatives has become increasingly common, without clear knowledge of health impacts. This uncertainty includes breastfeeding mothers and infants who may chronically ingest marijuana. Case Presentation: We present an infant with altered mental status initially thought to be the result of acute symptomatic exposure to tetrahydrocannabinol (THC). The infant subsequently developed classical symptoms of intussusception. Conclusion: This case raises the question of chronic THC exposure/ingestion in infants as a risk factor for intussusception. This association has been reported in adult populations, but not to date, in pediatric patients.