An evaluation of patient comfort levels during expression with a modified pumping program: a prospective proof of concept study.

Introduction: This study aimed to assess if the implementation of a gentle transition of vacuum mode into a breast pump suction pattern commonly used to initiate milk production would improve user comfort while expressing during the first four days postpartum.

Methods: This prospective study was conducted at OLVG hospital in the Netherlands in two sequential phases. Breastfeeding patients delivering >36 weeks gestation with an infant aged ≤96 h old and a clinical indication to express milk with a breast pump were recruited.

Breast shield design impacts milk removal dynamics during pumping: A randomized controlled non-inferiority trial.

Introduction: While many studies have investigated the importance of optimizing pumping patterns for milk removal, the influence of breast shield design on milk removal has not been the focus of extensive investigation. This study aimed to determine the effectiveness of breast shields with either a 105° or a 90° flange opening angle on breast drainage and milk volume expressed during pumping.

Material And Methods: This study was a cross-over, randomized controlled non-inferiority trial (Registration; NCT03091985).

Milk ejection patterns remain consistent during the first and second lactations.

Objective: Milk ejection is a critical physiological process for successful lactation in humans and without it little milk can be removed. Individual milk ejection patterns have been shown to remain consistent between breasts at different lactation stages and using different vacuum patterns with an electric breast pump. Little is known about the milk ejection characteristics during the second lactation period in the same mother.

Investigation of short-term variations in term breast milk composition during repeated breast expression sessions.

Background: Breast milk composition can be affected by several factors, and it can exhibit short-term (weekly) variations. Investigating variations in breast milk composition is important to accurately estimate nutrient requirements of the infant.

Objective: To investigate short-term changes in breast milk composition between left and right breasts, over a 3-week period within the first 6 months of lactation.

Simultaneous breast expression in breastfeeding women is more efficacious than sequential breast expression.

Introduction: Simultaneous (SIM) breast expression saves mothers time compared with sequential (SEQ) expression, but it remains unclear whether the two methods differ in milk output efficiency and efficacy.

Subjects And Methods: The Showmilk device (Medela AG, Baar, Switzerland) was used to measure milk output and milk ejection during breast expression (electric pump) in 31 Australian breastfeeding mothers of term infants (median age, 19 weeks [interquartile range, 10-33 weeks]). The order of expression type (SIM/SEQ) and breast (left/right) was randomized.

Variation in fat, lactose, and protein composition in breast milk over 24 hours: associations with infant feeding patterns.

Background: Data regarding the association between breast milk composition and infant feeding patterns (frequency and amount of breast milk taken) would help in understanding the regulation of food intake in breastfed infants.

Objective: This study examined the relationship between breast milk macronutrient concentration and patterns of milk intake in breastfeeding infants over a 24-hour breastfeeding period.

Methods: Mothers of healthy term infants (n = 15) collected pre- and postfeed breast milk samples from each feed at each breast over a 24-hour period.

Blood flow characteristics of the human lactating breast.

Background: Despite the increased metabolic activity of the lactating breast, no studies have been carried out to determine mammary blood flow (MBF) parameters or the relationship between MBF and milk production in women. The aim of this study was to measure the MBF in the internal mammary artery (IMA) and lateral thoracic artery (LTA) of lactating women and determine if these were related to milk production.

Methods: Blood flow in the IMA and LTA was measured with color Doppler ultrasound in 55 lactating women.

Investigation of short-term variations in casein and whey proteins in breast milk of term mothers.

Objectives: We investigated changes in breast milk whey and casein proteins, between fore and hind milk during breast expression, between breasts and within 24-hour period during breast-feeding. This has implications for developing an appropriate sampling protocol for investigating the influence of milk composition on gastric emptying and infants' feeding behaviour.

Methods: Breast milk samples were collected from mothers (n = 25) of healthy term infants ages 1 to 8 months.

Principles for maintaining or increasing breast milk production.

Breastfeeding rates in many developed countries remain low, and maternal perception of insufficient milk production is a major contributing factor. Mothers with a perception of insufficient milk should be advised that normal breastfeeding frequencies, suckling times, and amounts are very variable. If objective assessment confirms insufficient milk production, mothers should ensure optimal milk removal frequency and thorough breast drainage.

Dynamics of milk removal during simultaneous breast expression in women.

Objective: To investigate the dynamics of milk removal during breast expression.

Subjects And Methods: This study used a continuous weighing balance to determine changes in milk flow rate and their relationship to the proportion of milk removed over time and the percentage of the available milk removed during simultaneous expression (15 minutes) of the left and right breasts in 34 mothers of healthy, term, breastfeeding infants.

Results: Multiple milk ejections (5.

Comparison of the patterns of milk ejection during repeated breast expression sessions in women.

Background: This study aimed to investigate the consistency of milk ejections and milk expression characteristics within mothers at repeated expression sessions.

Methods: Twenty-five breastfeeding mothers expressed their breasts simultaneously on three occasions within 3 weeks, and follow-up visits were performed at 6, 9, and 12 months of lactation. During the 15-minute expression, milk was collected onto a continuous weigh balance to measure milk flow rate.

Using milk flow rate to investigate milk ejection in the left and right breasts during simultaneous breast expression in women.

Background: Milk ejection is essential for a successful lactation, however techniques to measure milk ejection in women are often complex and invasive. Recent research has demonstrated that at milk ejection, milk duct diameter increased in the breast (measured by ultrasound) at the same time as milk flow rate increased (measured using a weigh balance). This study aimed to evaluate a purpose-built continuous weigh balance (Showmilk, Medela AG) to measure changes in milk flow rate from the breast to identify milk ejections during milk expression.

Retention of the immunological proteins of pasteurized human milk in relation to pasteurizer design and practice.

Pasteurizing donor human milk inactivates bacteria that may be of concern to the preterm infant. However, current practice for Holder Pasteurization (62.5 degrees C for 30 min) is detrimental to the bioactivity of human milk.

The role of autopsy following pregnancy termination for fetal abnormality.

Objective: To review the frequency of autopsy following pregnancy termination for fetal anomaly and its contribution to subsequent counselling.

Methods: All medical pregnancy terminations for fetal anomaly performed after 14 weeks gestation from January 1997 to December 2006 were identified and the frequency of autopsy ascertained. The prenatal diagnosis prompting the termination was then compared with the autopsy data, and a diagnostic valuation was determined.