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- Title
Early initiation and regular breast milk expression reduces risk of lactogenesis II delay in at-risk Singaporean mothers in a randomised trial.
- Authors
Fok, Doris; Aris, Izzuddin Mohd; Jiahui Ho; Yiong-Huak Chan; Rauff, Mary; Lui, James K. C.; Cregan, Mark D.; Hartmann, Peter; Yap Seng Chong; Mattar, Citra N. Z.; Ho, Jiahui; Chan, Yiong-Huak; Lui, James Kc; Chong, Yap Seng; Mattar, Citra Nz
- Abstract
<bold>Introduction: </bold>Lactogenesis II (LaII) failure can be prevented in at-risk mothers with simple proactive interventions. In a randomised trial, we investigated the efficacy of early and regular breast milk expression in establishing LaII, using an electric double-breast pump.<bold>Methods: </bold>Mothers with uncomplicated singleton deliveries were randomised to intervention (n = 31) or control (n = 29) groups. The former commenced breast milk expression with an electric pump within one hour of delivery and maintained regular expression with direct breastfeeding. Control mothers directly breastfed without regular pump expression. Expressed milk volumes were analysed for citrate, lactose, sodium and protein.<bold>Results: </bold>Median time of LaII was Day 3 (interquartile range [IQR] 1 day) with intervention and on Day 4 (IQR 1 day) among controls (p = 0.03). Biochemical steady-state concentrations were achieved around early Day 4 (sodium, total protein) and Days 4-5 (citrate, lactose). Sodium, protein and lactose levels were similar in both groups over seven days, at 5.80 mM, 0.68 mM and -13.38 mM, respectively. Mean daily milk volume with intervention was 73.9 mL on Day 3 and 225.2 mL on Day 7, greater than controls (25.4 mL on Day 3 and 69.2 mL on Day 7; p < 0.2). Mean infant weights were similar on Day 8 at 3,477 g with intervention and 3,479 g among controls.<bold>Conclusion: </bold>LaII is established by postnatal Day 3 with early initiation of regular breast milk expression, a useful intervention for mothers at risk of early-onset breastfeeding failure.
- Subjects
BREAST milk; LACTOSE; ELECTRIC pumps; WEIGHT in infancy; BREAST pumps; LACTATION
- Publication
Singapore Medical Journal, 2019, Vol 60, Issue 2, p80
- ISSN
0037-5675
- Publication type
journal article
- DOI
10.11622/smedj.2018067