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A Comparison of the Timing of Hand Expressing of Human Milk With Breast Massage to Standard Care for Mothers of Preterm Infants: An Exploratory Pilot Using a Randomized Controlled Design.
J Hum Lact. 2023 05; 39(2):226-235.JH

Abstract

BACKGROUND

Globally, 10% of all births are preterm. Access to human milk via manual breast expression is required to reduce the incidence of adverse outcomes related to prematurity. However, there is little evidence to recommend optimum timing to commence breast expression in mothers of preterm infants or the most effective method.

RESEARCH AIMS

(1) To test feasibility of recruitment and compliance to the protocol and (2) to determine influence of using hand expressing and breast massage on milk production, engorgement, mastitis, and breastfeeding status at 3 months.

METHODS

This study was an exploratory parallel two-group, pilot randomized controlled trial. Mothers of preterm infants at a metropolitan maternity hospital in Queensland Australia (N = 31) were randomized to receive either hand expressing and breast massage within the 1st hr of birth or standard care, hand expressing within 6 hr of birth, to determine the influence on milk production, engorgement, mastitis, and breastfeeding status at 3 months.

RESULTS

Feasibility targets were not met; however, valuable learning from this trial uncovered barriers facing midwives in the birth suite to commencing expressing in the 1st hr of birth. There was no difference in occurrence of secondary outcomes, although trends support future study.

CONCLUSIONS

Overall, unpredictability of preterm birth influenced our ability to recruit participants. Important directions for future study design would benefit from incorporating expressing times up to 6 hr with a replicable breast massage.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Anderson LA
School of Nursing Midwifery and Social Work, University of Queensland, St Lucia, QLD, Australia.
Kildea S
Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Casuarina, NT, Australia. Mater Research, School of Nursing Midwifery and Social Work, University of Queensland, South Brisbane, QLD, Australia.
Lee N
School of Nursing Midwifery and Social Work, University of Queensland, St Lucia, QLD, Australia.
Kynoch K
Mater Health and QLD Centre for Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, South Brisbane, QLD, Australia. Australian Centre for Health Services Innovation (AusHSI) and School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia.
Gao Y
Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Casuarina, NT, Australia. Mater Research, School of Nursing Midwifery and Social Work, University of Queensland, South Brisbane, QLD, Australia.

MeSH

InfantInfant, NewbornFemaleHumansPregnancyMilk, HumanInfant, PrematureBreast FeedingPremature BirthMothersMastitisMassage

Pub Type(s)

Randomized Controlled Trial
Journal Article

Language

eng

PubMed ID

35543459

Citation

Anderson, Loretta A., et al. "A Comparison of the Timing of Hand Expressing of Human Milk With Breast Massage to Standard Care for Mothers of Preterm Infants: an Exploratory Pilot Using a Randomized Controlled Design." Journal of Human Lactation : Official Journal of International Lactation Consultant Association, vol. 39, no. 2, 2023, pp. 226-235.
Anderson LA, Kildea S, Lee N, et al. A Comparison of the Timing of Hand Expressing of Human Milk With Breast Massage to Standard Care for Mothers of Preterm Infants: An Exploratory Pilot Using a Randomized Controlled Design. J Hum Lact. 2023;39(2):226-235.
Anderson, L. A., Kildea, S., Lee, N., Kynoch, K., & Gao, Y. (2023). A Comparison of the Timing of Hand Expressing of Human Milk With Breast Massage to Standard Care for Mothers of Preterm Infants: An Exploratory Pilot Using a Randomized Controlled Design. Journal of Human Lactation : Official Journal of International Lactation Consultant Association, 39(2), 226-235. https://doi.org/10.1177/08903344221088789
Anderson LA, et al. A Comparison of the Timing of Hand Expressing of Human Milk With Breast Massage to Standard Care for Mothers of Preterm Infants: an Exploratory Pilot Using a Randomized Controlled Design. J Hum Lact. 2023;39(2):226-235. PubMed PMID: 35543459.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Comparison of the Timing of Hand Expressing of Human Milk With Breast Massage to Standard Care for Mothers of Preterm Infants: An Exploratory Pilot Using a Randomized Controlled Design. AU - Anderson,Loretta A, AU - Kildea,Sue, AU - Lee,Nigel, AU - Kynoch,Kathryn, AU - Gao,Yu, Y1 - 2022/05/11/ PY - 2023/4/20/medline PY - 2022/5/12/pubmed PY - 2022/5/11/entrez KW - International Board Certified Lactation Consultant KW - breast massage KW - breast pumping KW - breastfeeding KW - human milk expression KW - mastitis KW - milk supply KW - pilot study KW - prematurity SP - 226 EP - 235 JF - Journal of human lactation : official journal of International Lactation Consultant Association JO - J Hum Lact VL - 39 IS - 2 N2 - BACKGROUND: Globally, 10% of all births are preterm. Access to human milk via manual breast expression is required to reduce the incidence of adverse outcomes related to prematurity. However, there is little evidence to recommend optimum timing to commence breast expression in mothers of preterm infants or the most effective method. RESEARCH AIMS: (1) To test feasibility of recruitment and compliance to the protocol and (2) to determine influence of using hand expressing and breast massage on milk production, engorgement, mastitis, and breastfeeding status at 3 months. METHODS: This study was an exploratory parallel two-group, pilot randomized controlled trial. Mothers of preterm infants at a metropolitan maternity hospital in Queensland Australia (N = 31) were randomized to receive either hand expressing and breast massage within the 1st hr of birth or standard care, hand expressing within 6 hr of birth, to determine the influence on milk production, engorgement, mastitis, and breastfeeding status at 3 months. RESULTS: Feasibility targets were not met; however, valuable learning from this trial uncovered barriers facing midwives in the birth suite to commencing expressing in the 1st hr of birth. There was no difference in occurrence of secondary outcomes, although trends support future study. CONCLUSIONS: Overall, unpredictability of preterm birth influenced our ability to recruit participants. Important directions for future study design would benefit from incorporating expressing times up to 6 hr with a replicable breast massage. SN - 1552-5732 UR - https://www.unboundmedicine.com/medline/citation/35543459/A_Comparison_of_the_Timing_of_Hand_Expressing_of_Human_Milk_With_Breast_Massage_to_Standard_Care_for_Mothers_of_Preterm_Infants:_An_Exploratory_Pilot_Using_a_Randomized_Controlled_Design_ DB - PRIME DP - Unbound Medicine ER -