Point-of-Care Techniques to Identify Risks for Early, Unplanned Lactation Cessation Among Term Mother/Infant Dyads: An Integrative Review.

Objective: To summarize the evidence and identify gaps in the use of point-of-care (POC) techniques that hold potential to mitigate early, unplanned lactation cessation in term mother/infant dyads. Methods: An integrative review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search was conducted in the following electronic databases: MEDLINE (through PubMed), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Web of Science. Results: Of the 2,888 articles retrieved, 19 met the eligibility criteria and were included in this review. POC techniques included infant scales and a bedside ketone meter to measure infant weight change (n = 4); infant scales to measure mothers' own milk (MOM) transfer (test-weight) (n = 15); and ion-selective electrode probes and somatic cell counter to measure mammary gland function and health (n = 2). MOM transfer, as measured with infant scales, was the most frequent POC technique and was used in four primary ways: outcome variable, accurate standard to test other measures of MOM transfer, personalize intake of MOM components, and predict later lactation outcomes. Commercially available ion-selective electrode probes provide accurate and objective measures of paracellular pathway patency in the mammary gland, and have relevance for measurement of secretory activation achievement. Conclusion: Infant scales to measure weight change and MOM transfer and ion-selective electrodes are ideal POC measures to identify and mitigate lactation risk in the early postpartum period for term dyads. Translational studies that inform risk detection algorithms and novel models of lactation care that include these POC techniques are needed.