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At least 19 recordsLinked to original sources

PubMed2002

Effect of vacuum profile on breast milk expression using an electric breast pump.

The authors compared milk expression using 5 experimental vacuum patterns and a commercially available vacuum pattern ranging in cycle times (20 to 78 cycles/min) and vacuum curve dynamics in 30 mothers using an experimental, software-controlled electric breast pump. The volume of milk removed over 5 minutes differed (P = .0072) between patterns (range = 62.8 +/- 6.6 mL to 47.2 +/- 5.1 mL). However, there was no difference in the percentage of available milk removed (range = 99.4% +/- 15.1% to 70.6% +/- 8.6%). The rate of milk removal differed between patterns at both the beginning (1 minute) and end (1.5 minutes) of the expression period (P < .05). Peak vacuum chosen differed between patterns (P = .0085) but was not related to either the volume or percentage of available milk expressed. Breastfeeding characteristics did not differ between poor and successful expressers. These results show that breast milk expression by an electric breast pump can be influenced by the vacuum pattern.

Adult↗

PubMed1981

Fat content of expressed breast milk: a case for quality control.

Expressed breast milk used to feed preterm infants is precious and so, despite heterogeneity of composition, all available milk is used. A study of 274 samples of expressed breast milk supplied by preterm mothers and National Childbirth Trust donors showed pronounced variation in fat content as measured by the "creamatocrit" method. This was not due to differences between term and preterm mothers or between transitional and mature milk. The composition was affected by diurnal variation and method of collection. Substantial amounts of fat were also wasted as a result of continuous nasogastric feeding. Several milk samples did not contain enough fat to supply even a fraction of the recommended energy requirements of these infants. Some type of quality control over samples of expressed breast milk is clearly essential. The creamatocrit method is simple and feasible.

Female↗

PubMed2002

Efficacy of breast milk expression using an electric breast pump.

The authors compared breastfeeding and expression characteristics in 30 mothers of exclusively breastfeeding, healthy term infants. Mean (+/- SD) volume per breastfeed from one breast was 71.8 +/- 26.3 mL, and mean duration per breastfeed for one breast was 16.6 +/- 10.5 minutes. Mean volume of milk expressed in 5 minutes from one breast was 60.6 +/- 39.0 mL and corresponded to the expression of 99.4 +/- 82.6% of the milk stored in the breast. The rate of milk expression differed greatly between mothers (P = .0001) but remained constant for the first 2.5 minutes before decreasing with time (P = .0001). These results show the mean breastfeed volume was similar to the volume of milk expressed in a 5-minute period. Furthermore, this study is the first to establish protocols that allow for the objective determination of breast pump efficacy.

Adult↗

PubMedDate not supplied

Manual and pump methods of expression of breast milk.

This study was designed to compare two methods of breast milk expression, namely, the manual and the pumping method using a hand-held cylindric pump. The parameters evaluated were (i) the output of breast milk during milk expression sessions of 15 minutes' duration, and, (ii) the subjective preference of the method by the mothers. In the first phase, 22 mothers whose infants were on gavage feeding in the nursery, had 3 sittings each by the two methods on 4th and 5th postnatal days (66 expression). It was seen that the use of breast pump (Medela) was associated with significantly higher volume of breast milk expressed per session (41.57 +/- 16.05 ml vs. 21.7 +/- 10.5 ml, P < 0.001). In the second phase, 14 mothers had such sessions (42 each) not only on the 4th and 5th postnatal days, but lso on days 8 and 9. It was again seen that, the volume of breast milk expressed was greater by the pump method than the manual expression (on day 5 and 6 (46.8 +/- 26.3 ml vs 31.2 +/- 15.5 ml, P < 0.01) as well as on day 8 and 9 (50.40 +/- 11.2 ml vs 38.49 +/- 13.4 ml, P < 0.01). Subjectively, the pump expression was preferred by the mothers on day 4 & 5, while the manual expression was the preference on days 8 & 9. The use of breast pump is more efficient than the manual system of expression of breast milk among mothers whose infants are not directly breast-fed. It is recommended that in case the mothers prefer to use the manual method, let them express as much milk as possible by this method initially, and then follow it up with a short period of pumping to ensure complete evacuation of breasts.

Adult↗

PubMed2006

Breastfeeding duration in mothers who express breast milk: a cohort study.

BACKGROUND: The expression of breast milk allows a mother to be away intermittently from her infant while continuing to breastfeed. The aim of this study was to investigate the association between expression of breast milk and breastfeeding duration METHODS: A cohort study of 12 months duration. The mothers were recruited from two public maternity hospitals in Perth, Australia between mid-September 2002 and mid-July 2003. While in hospital, participating mothers completed a questionnaire that included questions on how they were feeding their newborn. Telephone interviews conducted at regular periods monitored changes in infant feeding practices, including expression of breast milk. Multivariate Cox regression analysis was used to explore the association between breast milk expression and the duration of any breastfeeding. RESULTS: A total of 587 mothers, or 55% of those eligible, participated in the study. Of these 93.5% were breastfeeding at discharge from hospital. Mothers who expressed breast milk (at one or more time periods) were less likely to discontinue any breastfeeding before six months (Relative Risk 0.71, 95% CI 0.52, 0.98) than those who had never expressed milk. CONCLUSION: This study found that mothers who express breast milk are more likely to breastfeed to six months (any breastfeeding). While further research is required in different cultures to confirm these results, the appropriate use of expressed breast milk may be a means to help mothers to achieve six months of full breastfeeding while giving more lifestyle options.

Journal Article↗

PubMed2004

Breast milk expression in the workplace: a look at frequency and time.

The objective of this article is to study a barrier for breastfeeding women working full-time outside the home: breast milk expression in the workplace. Data are from a large corporation that provides employee benefits. Mothers express breast milk about twice a day when infants are 4 months old (x = 2.2 +/- 0.8) and 6 months old (x = 1.9 +/- 0.6), with a significant decline in frequency (P <.05) comparing the 2 age groups. Most mothers spend 1 hour or less expressing breast milk when infants are 3 (82%) or 6 months old (96%), with a significant difference (P <.05) between the 2 age groups. Mothers of younger infants were no more likely to work fewer days per week than were mothers of older infants. Most women can express breast milk for 3- and 6-month-old infants in less than an hour, distributed in about 2 separate portions, in an employment environment supportive of breastfeeding.

Adult↗

PubMed1982

Enhancement of human rotavirus infectivity in a monkey kidney cell line by human expressed breast milk.

Eight of forty (20%) human expressed breast milks enhanced the infectivity of human rotavirus (HRV) when assayed by immunofluorescence in a monkey kidney cell line (LLC-MK2). This enhancement was demonstrated with two HRV strains, one derived from a fecal specimen of a child with acute gastroenteritis, the other a tissue culture adapted strain. The phenomenon could have important implications in the pathogenesis of HRV infections and in future vaccine programs.

Animals↗

PubMed2005

Randomised, double blind trial of oxytocin nasal spray in mothers expressing breast milk for preterm infants.

BACKGROUND: Human milk has considerable short and long term benefits for preterm infants, but mothers may experience difficulties in expressing breast milk for infants too immature or sick to breast feed. Oxytocin has been used to assist breast feeding and milk expression, but few data are available to support this intervention in the neonatal unit setting. AIM: To test the hypothesis that oxytocin nasal spray increases early milk output in mothers expressing milk for preterm infants. METHODS: A randomised, double blind trial of oxytocin nasal spray (100 microl per dose) versus placebo was conducted in mothers delivering infants <35 weeks gestation. Sprays were used before expression of milk using an electric pump up to day 5. MAIN OUTCOME: Total weight of milk expressed while using spray (study powered to detect >1SD difference between groups). SECONDARY OUTCOMES: Pattern of milk production; number of pumping sessions; weight/fat content of milk expressed during a fixed 20 minute period on day 5 ("physiological study"); mother's opinion of expressing and spray assessed by questionnaire. RESULTS: Fifty one mothers were randomised (27 oxytocin, 24 placebo). Total milk production did not differ between groups. Repeated measures analysis of variance suggested significantly (p = 0.001) different patterns of milk production, with initial faster production in the oxytocin group then convergence between groups. Parity did not influence the response to the intervention. No significant differences were seen in milk weight or fat content in the physiological study nor in mothers' opinions of milk expression and treatment. CONCLUSIONS: Despite marginal differences in the pattern of early milk production, the use of oxytocin nasal spray did not significantly improve outcome. Most mothers believed they were receiving the active spray, suggesting a significant placebo effect (supported by limited data from historical controls) and benefits from the extra breast feeding support available during the study.

Administration, Inhalation↗

PubMed1977

Adequacy of expressed breast milk for early growth of preterm infants.

Poor weight gain observed in preterm infants who were fed expressed breast milk compared with those fed a cows' milk formular prompted a detailed study of early postnatal growth in preterm infants fed these two milks. 68 infants were divided into two categories by gestational age at birth (i) 28-32 weeks (n=28), (ii) 33-36 weeks (n=40). They were randomly allocated to a feed of expressed breast milk or a milk formula (Ostermilk 1). Rates of weight gain, linear growth, and head circumference growth were evaluated over two periods: birth-1 month, 1-2 months. The younger group who were fed breast milk showed slower overall growth rates over the first month than those fed formula. In the second month, and for the older infants over both of the 2-monthly periods, growth rates were similar in the two feeding regimens. It is concluded that expressed breast milk is inadequate for the growth of very immature preterm infants during early postnatal life.

Animals↗

PubMed1982

Energy intake and weight gain of very low birthweight babies fed raw expressed breast milk.

The energy intake and weight gain of low birthweight infants (under 1500 g) fed expressed breast milk were measured. Between the second and fourth weeks of life the mean energy intake was 577 kJ (138 kcals)/kg/day and the mean weekly increase in weight 119 g/week. Feeding energy-rich hind milk to two babies increased their energy intake but had little effect on their rate of weight gain. There appeared to be no correlation between energy intake and weight gain, probably owing to variation in the absorption of nutrients from expressed breast milk. This study forms a basis for a comparison of weight gain in babies fed alternative regimens of artificial milks.

Aging↗

PubMed1989

Bacteriology of unheated expressed breast milk stored at room temperature.

Thirty samples of unheated expressed breast milk (EBM) from thirty lactating mothers, stored at room temperature (RT) and in the refrigerator (at +4 degrees C), were examined for the degree of bacterial contamination at two hourly intervals upto eight hours. All the EBM samples contained bacteria, mostly of normal skin flora; Staphylococcus albus 76.7%; Streptococcus viridans 40%. Potential pathogens were isolated in small numbers: Escherichia coli 26%, Streptococcus faecalis 13.6% and Staphylococcus aureus 6.7%. The bacterial colony counts (BCC) were consistently low; Mean initially 5.438 x 10(3) cfu/mm3 with a range of 0.15-23.1 x 10(3) cfu/mm3 and showed a significant reduction on storage in both EBM samples stored at RT and at +4 degrees C. The study proved that it is safe for mothers to keep unheated EBM at RT for at least eight hours before bacteria can multiply beyond unacceptable levels.

Female↗

PubMed2004

Is stored expressed breast milk an alternative for working Egyptian mothers?

Expression and storage of breast milk is way to maintain breastfeeding when mother and infant are separated, if the nutritional value can be conserved. Three expressed breast milk samples were collected from 61 healthy lactating mothers in Cairo, Egypt, for determination of total protein, fat, lactose and zinc content, as well as vitamins C, A and E concentrations. One sample was analysed immediately without storage, 1 after storage for 24 hours in a refrigerator (4 degrees C) and 1 after storage for 1 week in a home freezer (-4 degrees C to -8 degrees C). Refrigeration and freezing of breast milk caused a statistically significant decline in levels of vitamins C, A and E. Nevertheless, the values of all nutrients were still within the international reference ranges for mature breast milk.

Adolescent↗

PubMed2004

Bacteriological screening of expressed breast milk revealed a high rate of bacterial contamination in Chinese women.

A screening programme for expressed breast milk (EBM) revealed the alarming fact that our study group had the highest rate of contamination ever reported. The programme started in July 2002 and involved a group of Chinese women whose premature babies were in the neonatal intensive care unit. EBM was considered to be contaminated if there was any growth of pathogens, including Gram-negative bacteria, enterococci or Staphylococcus aureus, or if the total bacterial count was >10(5) cfu/mL. Of 59 samples from 23 mothers, 63% were contaminated. This high contamination rate could be due to the Chinese tradition of avoiding bathing for one month after childbirth. Previous studies have shown that feeding EBM rather than premature infant formula milk has advantages in terms of decreased incidence of necrotizing enterocolitis and neonatal sepsis. However, in this population, with such a high incidence of contaminated EBM, this may not be the case. Further studies to compare EBM with premature infant formula in this population are required.

Adult↗

PubMed2006

Normal neurologic and developmental outcome after an accidental intravenous infusion of expressed breast milk in a neonate.

Here we describe a premature male infant who was accidentally given 10 mL of expressed breast milk intravenously over a 3.5-hour period. Having survived this event with supportive care, this boy was attending regular school with no obvious neurologic or learning difficulties at 6 years of age. In 1998, after a query on an e-mail discussion group for health care providers in neonatology (NICU-net), we were informed of 8 similar events that proved fatal in 3 infants. A root-cause analysis revealed that accidental intravenous administration of breast milk or formula can be avoided by the use of color-coded enteral-administration sets with Luer connections that are not compatible with intravenous cannulas. The addition of methylene blue to feeds, or bolus enteral feeds (instead of continuous gastric feedings), may also help prevent such errors. These cases show the value of gathering information about rare but important events through a neonatal network. In addition, they confirm that prevention of medical error should focus on faulty systems rather than faulty people.

Child Development↗

PubMed2004

Analgesic effect of expressed breast milk in procedural pain in term neonates: a randomized, placebo-controlled, double-blind trial.

AIM: To assess the effectiveness of expressed breast milk (EBM) in reducing pain due to venepuncture, in term neonates, as measured by behavioural and physiological observations. METHODS: This randomized, placebo-controlled, double-blind trial involved 81 full-term neonates, up to 4 wk of postnatal age, who needed venepuncture for blood investigations. Two minutes before the venepuncture, in the intervention arm, 40 babies received 5 ml of EBM, while 41 babies in control group received 5 ml of distilled water (DW) as placebo. Two observers who were blinded to the intervention recorded the physiological (heart rate and oxygen saturation) and behavioural parameters [duration of crying and modified Neonatal Facial Coding Scores (NFCS)] after the venepuncture. RESULTS: There was no difference in the baseline characteristics of the neonates in the two groups. The duration of crying was significantly shorter in babies fed EBM [median 38.5 s, interquartile range (IQR) 9.5-57.5 s] than in those fed DW (median 90 s, IQR 28-210 s). The mean duration of crying in EBM group was shorter by 70.7 (95% confidence interval 36.6-104.9) s. The modified NFCS at 0, 1 and 3 min was significantly lower (p < 0.01) in the EBM than in the DW group. The change in heart rate and oxygen saturation was significantly lower in the EBM group and returned to baseline values sooner than in the DW group. CONCLUSION: Feeding 5 ml of EBM before venepuncture is effective in reducing symptoms due to pain in term neonates.

Analgesia↗

PubMed1979

Bacterial contamination of expressed breast milk.

In a study of breast milk collected into sterile bottles rinsed in 1% hypochlorite solution the hypochlorite solution adherent to the sides of the bottles apparently caused a large reduction in bacterial contamination of the milk after storage at 4 degrees C for up to four hours. Heating expressed breast milk at 62.5 degrees C for five minutes destroyed over 90% of the Escherichia coli, Staphylococcus aureus, and group B beta-haemolytic streptococci inoculated into the milk samples. Rinsing collecting bottles with hypochlorite solution may be valuable in collecting milk with a low bacterial content for human-milk banks. Furthermore, the currently accepted pasteurisation time of 30 minutes may be excessive.

Escherichia coli↗

PubMed1982

Energy balance, nitrogen balance, and growth in preterm infants fed expressed breast milk, a premature infant formula, and two low-solute adapted formulae.

Energy balance, nitrogen balance, and growth studies were done in 37 preterm infants (20 of very low birthweight) who were fed on expressed breast milk or on one of 3 formulae each of different composition, including a special premature formula and a highly adapted 'humanised' formula. The variability of breast milk composition was such that it would have been difficult to predict the infants' protein and energy intakes under normal nursing conditions. All measured parameters of nutritional performance were best in infants fed on the 'premature' formula and were reflected in greater weight gain, linear growth, and head growth. The nitrogen balance data suggest that the highly adapted formula, which had a protein content comparable with that of mature human milk, contained too little protein for small preterm infants.

Animals↗

PubMed1997

Contamination in expressed breast milk following breast cleansing.

The purpose of this study was to determine if preexpression breast cleansing reduced the bacterial count in expressed breast milk. The study involved the collection of 178 breast milk samples (89 matched samples); 38 matched samples were from mothers of term infants and 51 matched samples were from mothers of preterm infants. One half of the samples were collected following breast cleansing with Phisoderm and tap water. The other half were collected following breast cleansing with tap water only. Hand and equipment washing with Phisoderm and tap water preceded all sample collections. Storage containers were sterile. Samples were cultured for pathogenic and nonpathogenic bacteria and examined at 24 and 48 hours. Data were analyzed by Wilcoxon Matched-Pairs sign test and Chi square. Breast cleansing with Phisoderm and water was not more effective than water alone at reducing nonpathogenic bacteria or eliminating pathogenic bacteria. Mothers of preterm infants had higher levels of both nonpathogenic and pathogenic bacteria than mothers of full-term infants. The most common form of bacterial contamination was coagulase-negative Staphylococcus epidermidis. This particular bacteria is found in higher levels in the stools of breast fed infants than formula fed infants and it also the most common contaminant found in the blood of preterm infants who develop sepsis. The findings of this study reveal that chemical interventions may not be effective at rendering breast milk free from pathogenic bacteria. More research is needed to determine the optimal cleansing protocol to achieve bacterial decontamination of breast milk or to determine the clinically acceptable level of contamination based on the effects on infants.

Chi-Square Distribution↗