The study will follow a prospective cohort of racially and economically diverse mothers of premature infants for 3 weeks following delivery to test whether antenatal education of the support person of mothers may decrease time to initiation of breast pumping, decrease time to lactogenesis stage II and increase breast milk production.
Compelling evidence exists that breast milk helps protect premature infants from prematurity-specific morbidities, including feeding intolerance, late onset sepsis, and necrotizing enterocolitis. Unfortunately, mothers of VLBW infants often exhibit delayed lactogenesis stage II (when the milk "comes in") and inadequate breast milk production. Earlier initiation of breast milk expression following delivery is associated with increased lactation success. However, lack of nursing time and lack of hospital personal are significant barriers to the early initiation of milk expression in this population. The proposed study will follow a prospective cohort of racially and economically diverse mothers of premature infants for 3 weeks following delivery to test 1 primary aim and 1 secondary aim. Aim 1: will evaluate the feasibility of antenatal BM pumping education for SPs of mothers of preterm infants. Issues related to recruitment, randomization acceptance of the intervention, and refinement of the education materials and process will be scrutinized. Aim 2 will estimate variability of outcome measurements and effect sizes needed to calculate the sample size for a subsequent larger, adequately powered, randomized clinical trial. Eligible women and their SP will be randomly assigned to one of two groups. Group 1 will receive a prenatally delivered lactation educational program including video recordings, a demonstration of how the pump works and will have a breast pump available in their room. The volume of breast milk produced, timing of lactation stage II, duration of lactation and stress during initial expression will be measured. In addition, breast milk sodium levels will be analyzed on Day 1-7, Day 14 and 21.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
90
The support person (SP) of mothers at risk for preterm birth will be educated on how to use a breast pump and instructions regarding breast milk expression and have a pump in their hospital room
UF Health at the University of Florida
Gainesville, Florida, United States
Onset of Lactogenesis Stage II Through Volume Attainment
Time in hours until mothers pump at least 20 mL of milk in 2 consecutive pumping sessions
Time frame: Up to 96 Hours
Breast Milk Production on Day 1
Volume of breast milk produced from 0-24 hours postpartum
Time frame: 0-24 hours postpartum
Time to Breast Pumping Initiation
Time to mothers beginning to pump breasts after delivery
Time frame: first 24 hours after delivery
Breast Milk Production Day 2
Volume of breast milk produced on day 2 postpartum
Time frame: Day 2 postpartum
Milk Production Day 3
Volume of milk produced on Day 3 postpartum
Time frame: 3 days postpartum
Breast Milk Production Day 4
Volume of breast milk produced on Day 4 postpartum
Time frame: Day 4 postpartum
Breast Milk Production on Day 5
Volume of breast milk produced on Day 5 postpartum
Time frame: Day 5 postpartum
Breast Milk Production Day 6
Volume of breast milk produced on Day 6 postpartum
Time frame: Day 6 postpartum
Breast Milk Production Day 7
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Volume of milk produced on Day 7 postpartum
Time frame: Day 7 postpartum
Breast Milk Production Day 14
Volume of breast milk produced on Day 14 postpartum
Time frame: Day 14 postpartum
Breast Milk Production Day 21
Volume of breast milk produced on Day 21 postpartum
Time frame: 21 days postpartum