TY - JOUR
T1 - A Comparison of the Timing of Hand Expressing of Human Milk With Breast Massage to Standard Care for Mothers of Preterm Infants
T2 - An Exploratory Pilot Using a Randomized Controlled Design
AU - Anderson, Loretta A.
AU - Kildea, Sue
AU - Lee, Nigel
AU - Kynoch, Kathryn
AU - Gao, Yu
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by a grant provided by The Mater Foundation under the Betty McGrath Fellowship Scheme.
Publisher Copyright:
© The Author(s) 2022.
PY - 2023/5
Y1 - 2023/5
N2 - Background:Globally, 10% of all births are preterm. Access to human milk via manual breast expression is required to reduce the incidence of adverse outcomes related to prematurity. However, there is little evidence to recommend optimum timing to commence breast expression in mothers of preterm infants or the most effective method.Research Aims:(1) To test feasibility of recruitment and compliance to the protocol and (2) to determine influence of using hand expressing and breast massage on milk production, engorgement, mastitis, and breastfeeding status at 3 months.Methods:This study was an exploratory parallel two-group, pilot randomized controlled trial. Mothers of preterm infants at a metropolitan maternity hospital in Queensland Australia (N = 31) were randomized to receive either hand expressing and breast massage within the 1st hr of birth or standard care, hand expressing within 6 hr of birth, to determine the influence on milk production, engorgement, mastitis, and breastfeeding status at 3 months.Results:Feasibility targets were not met; however, valuable learning from this trial uncovered barriers facing midwives in the birth suite to commencing expressing in the 1st hr of birth. There was no difference in occurrence of secondary outcomes, although trends support future study.Conclusions:Overall, unpredictability of preterm birth influenced our ability to recruit participants. Important directions for future study design would benefit from incorporating expressing times up to 6 hr with a replicable breast massage.
AB - Background:Globally, 10% of all births are preterm. Access to human milk via manual breast expression is required to reduce the incidence of adverse outcomes related to prematurity. However, there is little evidence to recommend optimum timing to commence breast expression in mothers of preterm infants or the most effective method.Research Aims:(1) To test feasibility of recruitment and compliance to the protocol and (2) to determine influence of using hand expressing and breast massage on milk production, engorgement, mastitis, and breastfeeding status at 3 months.Methods:This study was an exploratory parallel two-group, pilot randomized controlled trial. Mothers of preterm infants at a metropolitan maternity hospital in Queensland Australia (N = 31) were randomized to receive either hand expressing and breast massage within the 1st hr of birth or standard care, hand expressing within 6 hr of birth, to determine the influence on milk production, engorgement, mastitis, and breastfeeding status at 3 months.Results:Feasibility targets were not met; however, valuable learning from this trial uncovered barriers facing midwives in the birth suite to commencing expressing in the 1st hr of birth. There was no difference in occurrence of secondary outcomes, although trends support future study.Conclusions:Overall, unpredictability of preterm birth influenced our ability to recruit participants. Important directions for future study design would benefit from incorporating expressing times up to 6 hr with a replicable breast massage.
KW - breast massage
KW - breast pumping
KW - breastfeeding
KW - human milk expression
KW - International Board Certified Lactation Consultant
KW - mastitis
KW - milk supply
KW - pilot study
KW - prematurity
UR - http://www.scopus.com/inward/record.url?scp=85130281320&partnerID=8YFLogxK
U2 - 10.1177/08903344221088789
DO - 10.1177/08903344221088789
M3 - Article
C2 - 35543459
AN - SCOPUS:85130281320
SN - 0890-3344
VL - 39
SP - 226
EP - 235
JO - Journal of Human Lactation
JF - Journal of Human Lactation
IS - 2
ER -