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Extra fluids for breastfeeding mothers for increasing milk production.

Abstract

BACKGROUND

Breastfeeding is known to be the biological norm. Despite this, many women wean their babies because of perceived insufficient breast milk production. Mothers are sometimes advised to increase their fluid intake in the hope that this could improve breast milk production. The effect of extra fluid on human breast milk production is not well established, however.

OBJECTIVES

To assess the effect of extra fluid for breastfeeding mothers on milk production/supply and infant growth.

SEARCH METHODS

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (27 April 2014), MEDLINE (1966 to 27 April 2014), African Journals Online (27 April 2014) and reference lists of retrieved studies.

SELECTION CRITERIA

Randomised controlled trials and quasi-randomised controlled trials on extra fluids for breastfeeding mothers.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed the potential studies for inclusion and assessed trial quality.

MAIN RESULTS

Five trial reports were retrieved using the search strategies. Four trials were excluded. We did not identify any randomised controlled trials for inclusion but we included one quasi-randomised study (involving 210 women) that evaluated the effect of extra fluid for breastfeeding mothers on breastfeeding outcomes. The study was considered to be at a high risk of bias. Only one of this review's primary outcomes was reported (breast milk production (as defined by the trialist)) but data were not in a suitable format for analysis (no standard deviations or standard errors were reported). The trialist reported that advising women to drink extra fluids did not improve breast milk production. No data were reported for the review's other primary outcomes: satisfactory weight gain in the infant (as defined by the trialists) and duration of exclusive breastfeeding (months). Similarly, no data were reported for any of this review's secondary outcomes: duration of any breastfeeding; mother's satisfaction with breastfeeding; hydration in mother; dehydration in the infant; or episodes of gastrointestinal illness.

AUTHORS' CONCLUSIONS

This review only identified one small quasi-randomised controlled trial of low quality and high risk of bias. The study provided limited data on only one of this review's primary outcomes, breast milk production, but the data were not reported in a format that permitted further analysis. The trialist reported that extra fluids did not improve breast milk production. However, this outcome was measured by using test feeds (also known as test weighing). In the 1950s, when the study was conducted, it was common for babies in developed countries to be weighed before and after a feed, known as test weighing or test feeding. However, this practice is not now routinely practiced for term infants due to concerns about lack of precision as a measure of breast milk production. The included study did not report on this review's other primary outcomes (satisfactory weight gain in the infant or duration of exclusive breastfeeding) nor any of the review's secondary outcomes.The effect of additional fluids for breastfeeding mothers remains unknown, due to a lack of well-conducted trials. However, because the physiological basis for any such improvement remains unclear, the conduct of further clinical trials may not be a priority. There is not enough evidence to support an increased fluid intake beyond what breastfeeding mothers are likely to require to meet their physiological needs.

Authors+Show Affiliations

Department of Nursing, College of Medicine, University of Ibadan, Ibadan, Nigeria.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review

Language

eng

PubMed ID

24916640

Citation

Ndikom, Chizoma M., et al. "Extra Fluids for Breastfeeding Mothers for Increasing Milk Production." The Cochrane Database of Systematic Reviews, 2014, p. CD008758.
Ndikom CM, Fawole B, Ilesanmi RE. Extra fluids for breastfeeding mothers for increasing milk production. Cochrane Database Syst Rev. 2014.
Ndikom, C. M., Fawole, B., & Ilesanmi, R. E. (2014). Extra fluids for breastfeeding mothers for increasing milk production. The Cochrane Database of Systematic Reviews, (6), CD008758. https://doi.org/10.1002/14651858.CD008758.pub2
Ndikom CM, Fawole B, Ilesanmi RE. Extra Fluids for Breastfeeding Mothers for Increasing Milk Production. Cochrane Database Syst Rev. 2014 Jun 11;(6)CD008758. PubMed PMID: 24916640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Extra fluids for breastfeeding mothers for increasing milk production. AU - Ndikom,Chizoma M, AU - Fawole,Bukola, AU - Ilesanmi,Roslyn E, Y1 - 2014/06/11/ PY - 2014/6/12/entrez PY - 2014/6/12/pubmed PY - 2015/10/3/medline SP - CD008758 EP - CD008758 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 6 N2 - BACKGROUND: Breastfeeding is known to be the biological norm. Despite this, many women wean their babies because of perceived insufficient breast milk production. Mothers are sometimes advised to increase their fluid intake in the hope that this could improve breast milk production. The effect of extra fluid on human breast milk production is not well established, however. OBJECTIVES: To assess the effect of extra fluid for breastfeeding mothers on milk production/supply and infant growth. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (27 April 2014), MEDLINE (1966 to 27 April 2014), African Journals Online (27 April 2014) and reference lists of retrieved studies. SELECTION CRITERIA: Randomised controlled trials and quasi-randomised controlled trials on extra fluids for breastfeeding mothers. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the potential studies for inclusion and assessed trial quality. MAIN RESULTS: Five trial reports were retrieved using the search strategies. Four trials were excluded. We did not identify any randomised controlled trials for inclusion but we included one quasi-randomised study (involving 210 women) that evaluated the effect of extra fluid for breastfeeding mothers on breastfeeding outcomes. The study was considered to be at a high risk of bias. Only one of this review's primary outcomes was reported (breast milk production (as defined by the trialist)) but data were not in a suitable format for analysis (no standard deviations or standard errors were reported). The trialist reported that advising women to drink extra fluids did not improve breast milk production. No data were reported for the review's other primary outcomes: satisfactory weight gain in the infant (as defined by the trialists) and duration of exclusive breastfeeding (months). Similarly, no data were reported for any of this review's secondary outcomes: duration of any breastfeeding; mother's satisfaction with breastfeeding; hydration in mother; dehydration in the infant; or episodes of gastrointestinal illness. AUTHORS' CONCLUSIONS: This review only identified one small quasi-randomised controlled trial of low quality and high risk of bias. The study provided limited data on only one of this review's primary outcomes, breast milk production, but the data were not reported in a format that permitted further analysis. The trialist reported that extra fluids did not improve breast milk production. However, this outcome was measured by using test feeds (also known as test weighing). In the 1950s, when the study was conducted, it was common for babies in developed countries to be weighed before and after a feed, known as test weighing or test feeding. However, this practice is not now routinely practiced for term infants due to concerns about lack of precision as a measure of breast milk production. The included study did not report on this review's other primary outcomes (satisfactory weight gain in the infant or duration of exclusive breastfeeding) nor any of the review's secondary outcomes.The effect of additional fluids for breastfeeding mothers remains unknown, due to a lack of well-conducted trials. However, because the physiological basis for any such improvement remains unclear, the conduct of further clinical trials may not be a priority. There is not enough evidence to support an increased fluid intake beyond what breastfeeding mothers are likely to require to meet their physiological needs. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/24916640/Extra_fluids_for_breastfeeding_mothers_for_increasing_milk_production_ DB - PRIME DP - Unbound Medicine ER -