Predictors of expressed breast milk volume in mothers expressing milk for their preterm infant

BACKGROUND: Timely delivery and magnesium sulfate (MgSO4) are mainstay in the treatment of preeclampsia with severe features (PWSF). Premature delivery, severity of illness and mother-infant separation may increase the risk for breastfeeding (BF) initiation failure. OBJECTIVE: To compare BF initiation among women with late-onset PWSF for women with late-onset preeclampsia without severe features (WOSF). METHODS: Retrospective study of 158 women with PWSF and 104 with WOSF who delivered at ≥34 weeks. Intention to BF, formula feed (FF) or partially BF was declared prenatally. At discharge, exclusive BF included direct BF or direct BF with expressed breast milk (EBM). RESULTS: PWSF and WOSF groups were similar in age, race, and obstetric history. PWSF and WSOF differed in primiparity (65 & 51%), late preterm births (73 vs 15%), admission to NICU (44 &17%) and mother (5 & 4d) and infant (6 & 3d) hospital stay. Both groups were similar in intention to BF (80 & 84%), to FF (16 & 13%) and to partially BF (5 & 5%). At discharge, exclusive BF (37 & 39%), partial BF (33 & 31%) and FF (30 & 30%) were similar. Exclusive BF in the PWSF group was 43% direct BF, 28% direct BF and EBM and 29% EBM alone whereas in the WOSF group exclusive BF was 93% direct BF and 7% direct BF and EBM. CONCLUSION: BF initiation rates for women with PWSF and WOSF were similar. EBM alone or with direct BF enabled infants in the PWSF group to exclusively BF at discharge.

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Domperidone and maternal milk volume in mothers of premature newborns

Paediatrica Indonesiana ◽

10.14238/pi57.1.2017.18-22 ◽

2017 ◽

Vol 57 (1) ◽

pp. 18 ◽

Cited By ~ 2

Author(s):

Tengku Ellya Fazilla ◽

Guslihan Dasa Tjipta ◽

Muhammad Ali ◽

Pertin Sianturi

Keyword(s):

Placebo Group ◽

Breast Milk ◽

Milk Production ◽

Controlled Trial ◽

Maternal Milk ◽

Premature Newborns ◽

Breast Milk Production ◽

Days Of Therapy ◽

Significant Difference ◽

Milk Volume

Background Mothers of premature newborns often have difficulty giving adequate breast milk volume to their infants. Domperidone is an antagonist of peripheral dopamine receptors and believed to increase breast milk production. In Indonesia, no study has been done to date on the effect of domperidone on maternal milk production in mothers of premature newborns. Objective To evaluate the effect of domperidone on milk production in mothers of premature newborns who failed to lactate.Methods A randomized controlled trial was conducted from July to December 2012 in the Perinatology Unit, Haji Adam Malik Hospital, Medan. Mothers of premature newborns were given lactation counseling for 7 days in order to increase their milk production. Mothers who failed to lactate after that time were enrolled in the study. Fifty subjects were assigned to receive either domperidone or a placebo for 7 days. Milk volume was measured every 2 hours (from 7 am to 9 pm), in the 24 hours before starting therapy, and on the 7th and 10th days (the 10th day being 3 days after stopping therapy). Results This study involved 25 mothers in the domperidone groups and 25 others in placebo group. After 7 days of therapy, mean breast milk volume was significantly higher in the domperidone group than in the placebo group [181.6 (SD 80.2) vs. 72.4 (SD 57.8) mL, respectively; 95%CI of differences 69.36 to 148.93; P=0.0001]. At day 10, breast milk production remained significantly higher in the domperidone group. Furthermore, in the domperidone group, no significant difference in mean breast milk volumes was noted between the 7th and 10th days (P=0.65). Conclusion In mothers of premature newborns who failed to lactate, domperidone therapy for 7 days causes significantly higher milk production compared to placebo.

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