Combining hand techniques with electric pumping increases the caloric content of milk in mothers of preterm infants

Abstract

Objective: We previously reported that preterm mothers' milk production can exceed levels of term mothers by using early hand expression and hands-on pumping (HOP) with the highest production (955 ml per day) in frequent users of hand expression. In this study, we compared milk composition between mothers stratified by early hand expression frequency.Study Design: A total of 67 mothers of infants <31 weeks gestation were instructed on hand expression and HOP. Subjects submitted expression records and 1-ml samples from each pumping session over 24 h once weekly for 8 weeks.Result: 78% (52/67) of mothers completed the study. But for Week 1, no compositional differences (despite production differences) were noted between the three groups. Protein and lactose tracked reported norms, but fat and energy of mature milk (Weeks 2-8) exceeded norms, 62.5 g l À1 per fat and 892.7 cal l À1 (26.4 cal oz À1 ), respectively. Conclusion:Mothers combining manual techniques with pumping express high levels of fat-rich, calorie-dense milk, unrelated to production differences.

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

“…In that study, the mean daily volume of milk expressed by week 8 was 820 mL/day, with a higher value—955 mL/day—in mothers who had expressed more than five times per day in the first 3 days. The use of subsequent ‘hands-on pumping’, involving compression of the breast and massaging firmer areas to extract milk, combined with pumping also had beneficial effects for milk volume and for fat content 17. Mothers taught this technique had higher daily milk volumes despite pumping less frequently.…”

Macronutrient content of donor human breast milk

“…In particular it would be interesting to know if certain women always produced energy-dense milk and if so why. There is some evidence that combined hand and electric pumping increases the energy content of milk 6. However our donors do not receive specific instructions on the timing or mode of expression, other than it can be hand expressed or pump expressed but not ‘drip’ collected milk.…”

Field and laboratory methods in human milk research

“…There is a growing body of evidence, however, that suggests pumps alter milk composition by evaporating water content and artificially changing milk composition. Moreover, the use of the pump can affect milk synthesis during the subsequent feed (De Curtis and Rigo, 2012;Morton et al, 2012). Additionally, pumps require sterilization between uses and are not recommended for multiperson use, as there is a risk of spreading infection between mothers.…”