Shaare Zedek Medical Center, Jerusalem, Israel.
The Faculty of Medicine of the Hebrew University, Jerusalem, Israel.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):8249-8256. doi: 10.1080/14767058.2021.1969357. Epub 2021 Aug 29.
In preterm infants, the use of human milk is associated with unique benefits. However, successful breast feeding rates and prolonged breastfeeding duration is often reduced in preterm infants. Nevertheless, early initiation of breast expression after birth is believed to be one of the major variables that should improve the odds of successful breastfeeding. Hence, we aimed to assess correlation between timing of milk expression initiation and volume produced in regards to mode-of-delivery.
Prospective, observational study. Mothers delivering infants weighing < 1500 g measured 24-h milk volumes on days 1-7, 14, and 21.
Mothers delivering vaginally ( = 11) expressed milk sooner (3.82 ± 5.03 h) than mothers in the cesarean group ( = 42; 11.5 ± 9.1 h). There were no significant differences in daily number of expressions (i.e. day 1 3.6 ± 1.6 versus 2.5 ± 2.1, = .125) or daily volume (i.e. day 1 - 7.5 ± 6.1 ml versus 11.6 ± 22.9 ml, = .563), until day 6 from which, both were lower in the cesarean group (i.e. day 21 - number - 6.0 ± 1.3 versus 4.6 ± 1.7, = .029; volume - 796 ± 465ml versus 435 ± 368ml, = .018). Expressed volume initially did not correlate with earlier expression, however, latter expressed volume inversely correlated with earlier expression. In multivariate-analysis, mode of delivery, gestational age, and daily number of expressions were correlated with volumes on day 21 ( = .001).
Earlier human-milk expression is related to volumes on the second and the third week of lactation. This is overwhelmed by delivery mode, and by frequent milk expression from day 2. When early milk expression is not possible, more frequent milk expression might help increasing volumes.
在早产儿中，使用人乳与独特的益处相关。然而，早产儿的母乳喂养成功率和持续时间往往会降低。尽管如此，人们认为产后尽早开始挤奶是提高母乳喂养成功率的主要变量之一。因此，我们旨在评估分娩方式与挤奶开始时间和产奶量之间的相关性。
前瞻性观察性研究。对体重<1500g 的产妇进行 24 小时挤奶量测量，在第 1-7、14 和 21 天进行测量。
阴道分娩的产妇（ = 11）比剖宫产产妇（ = 42）更早开始挤奶（3.82 ± 5.03 h）。剖宫产组每天挤奶次数（第 1 天 3.6 ± 1.6 次与 2.5 ± 2.1 次， = .125）或每天产奶量（第 1 天 - 7.5 ± 6.1 ml 与 11.6 ± 22.9 ml， = .563）均无显著差异，但从第 6 天开始，剖宫产组均较低（第 21 天 - 第 6 天，次数 - 6.0 ± 1.3 次与 4.6 ± 1.7 次， = .029；量 - 796 ± 465ml 与 435 ± 368ml， = .018）。最初，挤出量与早期表达量无相关性，但随后的表达量与早期表达量呈反比相关。在多变量分析中，分娩方式、胎龄和每日挤奶次数与第 21 天的产奶量相关（ = .001）。
早期的人乳表达与泌乳第 2 周和第 3 周的产奶量有关。这被分娩方式和第 2 天开始的频繁挤奶所掩盖。当无法尽早进行人乳表达时，更频繁地进行人乳表达可能有助于增加产奶量。
