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Milk Volume on Day 4 and Income Predictive of Lactation Adequacy at 6 Weeks of Mothers of Nonnursing Preterm Infants.
. Hill PD, Aldag JC. J Perinatal Neonat Nurs 2005: 19(3):273-282
Mothers of preterm infants who are dependent on breast pumps are at high risk for difficulty in maintaining an adequate milk supply. Eighty-one mothers of preterm infants = 1500 g and = 31 weeks who planned to lactate at least 12 weeks were recruited from 4 tertiary care NICUs. Basic demographic and perinatal data were collected and mothers recorded milk pumping times and volumes in a logbook. Mothers were instructed to express milk at least 8 times per day for a minimum of 10 minutes or until one breast was no longer dripping, then for another 2 minutes. Adequate milk volume was defined as = 500 mL/day at week 6. When compared to the mothers with adequate milk production, the mothers with inadequate milk production |
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delivered significantly earlier (27 vs 28 wks, p 0.045), had lower infant birth weight (936 vs. 1108 g, p 0.004), began breast stimulation later (28 vs 21 hrs, p 0.046), fewer had decided to breastfeed prior to pregnancy (54% vs. 80%, p 0.019), fewer engaged in skin-to-skin care (32% vs. 65%, p 0.006) and fewer had income levels = $50,000 (37% vs. 53%, p 0.023). While controlling for income, the 27 mothers with lowest milk production (< 140 mL/day) at 4 days were 9.5 times more likely to have an inadequate milk production at week 6 than the 54 mothers with higher milk production. Controlling for day 4 milk production, lower annual income mothers (< $50,000) were 5 times more at risk of inadequate milk production than those with higher income (= $50,000) at week 6.
This study underscores the importance of establishing a full milk supply in the early days of lactogenesis. Day 4 milk volume, along with income, are important predictors of milk adequacy at week 6. Nancy E. Wight MD, IBCLC, FABM, FAAP |
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