T M Nicole Manshanden, Danielle K Prime, Fedde Scheele, Joost Velzel
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引用次数: 0
Abstract
Purpose: To assess whether adding 5 minutes of slower, nutritive suction cycles to a standard 15-minute breast pump initiation program increases expressed milk volume during the first 4 days postpartum. Background : Early and effective colostrum removal is critical for breastfeeding success and neonatal health. Standard initiation suction patterns are primarily non-nutritive and may be suboptimal for colostrum extraction.
Methods: This prospective pilot study was conducted at OLVG hospital in the Netherlands. Breastfeeding patients (n = 40) who gave birth after 36 weeks gestation with an infant aged ≤96-hour old and a clinical indication to express milk with a breast pump were recruited. Patients participated in one single 20-minute breast expression session using a hospital-grade electric breast pump with a 15 minute predominantly non-nutritive standard suction pattern followed by 5 minutes with a nutritive suction pattern. The primary outcome was the difference in the total expression volume after 20 min compared to 15 min of expression. Secondary outcomes were differences in expression volume by postpartum day, parity, mode of birth, and prior experience breastfeeding.
Results: The study found that the primary outcome total colostrum/milk expression volume after 20 minutes was significantly improved compared to 15 minutes of pumping (4.69 ml vs 7.6 ml, P < .001). With the additional 5 minutes yielding 36% of the total milk yield.
Conclusions: This study suggests an improvement in milk expression volume driven by the implementation of 5 minutes of additional of nutritive breast pump suction cycles.
Implications for practice and research: This pilot study contributes to novel insights into milk removal dynamics in the first days after birth.
Trial registration: Registered on clinical trials.gov NCT04619212. Date of registration: November 6, 2020.
目的:评估在标准的15分钟吸奶器启动程序中增加5分钟较慢的营养吸引周期是否会增加产后4天的泌乳量。背景:早期和有效的初乳清除是母乳喂养成功和新生儿健康的关键。标准的起始吸吸方式主要是非营养的,对于初乳的提取可能是次优的。方法:本前瞻性先导研究在荷兰OLVG医院进行。招募了妊娠36周后分娩且婴儿年龄≤96小时且临床指征需要吸奶器泌乳的母乳喂养患者(n = 40)。患者使用医院级电动吸奶器进行一次20分钟的乳房表达,其中15分钟主要是非营养性标准吸吸模式,然后进行5分钟营养性吸吸模式。主要结果是20分钟后总表达量与15分钟后的差异。次要结局是产后天数、胎次、出生方式和既往母乳喂养经验的表达量差异。结果:研究发现,与15分钟吸乳相比,20分钟后总初乳/乳汁表达量显著提高(4.69 ml vs 7.6 ml)。结论:本研究表明,实施5分钟的额外营养吸奶器吸乳周期可以改善乳汁表达量。对实践和研究的启示:这项初步研究有助于对出生后第一天的乳汁去除动力学的新见解。试验注册:在clinical trials.gov注册NCT04619212。报名日期:2020年11月6日。
期刊介绍:
The Journal of Perinatal and Neonatal Nursing (JPNN) strives to advance the practice of evidence-based perinatal and neonatal nursing through peer-reviewed articles in a topic-oriented format. Each issue features scholarly manuscripts, continuing education options, and columns on expert opinions, legal and risk management, and education resources. The perinatal focus of JPNN centers around labor and delivery and intrapartum services specifically and overall perinatal services broadly. The neonatal focus emphasizes neonatal intensive care and includes the spectrum of neonatal and infant care outcomes. Featured articles for JPNN include evidence-based reviews, innovative clinical programs and projects, clinical updates and education and research-related articles appropriate for registered and advanced practice nurses.
The primary objective of The Journal of Perinatal & Neonatal Nursing is to provide practicing nurses with useful information on perinatal and neonatal nursing. Each issue is PEER REVIEWED and will feature one topic, to be covered in depth. JPNN is a refereed journal. All manuscripts submitted for publication are peer reviewed by a minimum of three members of the editorial board. Manuscripts are evaluated on the basis of accuracy and relevance of content, fit with the journal purpose and upcoming issue topics, and writing style. Both clinical and research manuscripts applicable to perinatal and neonatal care are welcomed.