Mother And late Preterm Lactation Study (MAPLeS): a randomised controlled trial testing the use of a breastfeeding meditation by mothers of late preterm infants on maternal psychological state, breast milk composition and volume, and infant behaviour and growth

Abstract

Background: Late preterm infants suffer from more complications and are less likely to be breastfed compared to term infants and their mothers experience higher levels of stress than mothers with term infants. The physiological or hormonal responses that influence milk ejection, milk production, and/or maternal behaviour are possible mechanisms by which maternal distress could negatively influence breastfeeding success. Maternal mood might also affect infant behaviour (feeding, sleeping, and crying) through changes in milk volume and composition, and consequently breastfeeding success and infant growth. Previous research, using relaxation therapy in 64 Malaysian first-time mothers breastfeeding their full-term infants, demonstrated that the therapy was effective in reducing maternal stress and improving infant growth. We hypothesise that expected benefits are even greater in a more vulnerable population where additional breastfeeding support is especially needed, such as in mothers of late preterm infants. Methods/design: This protocol describes our randomised controlled trial that tests whether a breastfeeding meditation audio reduces maternal stress in mothers of late preterm infants in London. Home visits will be conducted at 2-3 and 6-8 weeks post-delivery. Participants will be randomised to a control group or an intervention group, where mothers will be asked to listen to a meditation tape on a daily basis while breastfeeding. The main outcomes of the intervention will be maternal stress markers and infant weight Z-score. Potential mediators will be the secondary outcomes and include breast milk macronutrient and hormone levels (ghrelin, leptin, cortisol, and adiponectin), milk volume assessed by 48-h test-weighing, and maternal engagement with the

Maternal-focused interventions to improve infant growth and nutritional status in low-middle income countries: A systematic review of reviews

“…They also found a significant effect on the duration of sleep at 6–8 weeks and reduced cortisol concentrations in breastmilk [ 101 ]. Relaxation therapy is a fast-evolving area of research [ 102 , 103 ]; other context-specific interventions that relieve maternal stress while breastfeeding could have similar effects.…”

Factors Associated with Exclusive Breastfeeding of Late Preterm Infants in Neonatal Hospital: Cross-Sectional Study

“…Однако, по данным когортных исследований, поздние недоношенные в сравнении с доношенными новорожденными реже получают полноценное грудное вскармливание в первые 10 нед жизни [14]. Обеспечение этих младенцев материнским молоком во многих стационарах ограничено в связи с особенностями становления лактации у матерей и наличием факто ров, препятствующих прикладыванию ребенка к груди [8,15]. Продвижение грудного вскармливания наиболее успешно при раннем начале вскармливания недоношенных грудным молоком (оптимально -в течение первого часа после рождения), регулярных контактах младенца с матерью («кожа-к-коже»), а при вынужденном раздельном пребывании матери и ребенка несомненна значимость регулярного сцеживания грудного молока для сохранения лактации [8,16,17].…”

“…Среди материнских факторов риска нарушения лактогенеза при поздних преждевременных родах указываются многоплодная беременность, осложнение беременности, оперативное родоразрешение, как правило, приводящее к раздельному пребыванию с ребенком после его рождения и отсутствию контакта «кожа-к-коже» [20,22]. Помимо этого, для матерей недоношенных детей характерен высокий уровень тревожности (психологический дистресс), что тормозит становление лактационной доминанты и приводит к запоздалой и недостаточной лактации [8,15,22].…”

A survey among healthcare professionals from seven countries reported diverse nutritional practices of late preterm infants

“…Late preterm infants (LPT) who are born between 34 and 36 completed weeks constitute around 74% of all preterm births, and this segment of neonates is increasing globally. They are as vulnerable as more premature infants to acute health risks such as hypoglycaemia and hyperbilirubinemia during hospitalisation 1,2 . In addition, LPT are at higher risk for long‐term health complications such as overweight, cognitive and neurodevelopmental delay as compared to term infants 3 …”

“…They are as vulnerable as more premature infants to acute health risks such as hypoglycaemia and hyperbilirubinemia during hospitalisation. 1,2 In addition, LPT are at higher risk for long-term health complications such as overweight, cognitive and neurodevelopmental delay as compared to term infants. 3 Lately, several attempts were made to propose some forms of nutritional guidance/recommendations for LPT.…”