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Preterm Labor
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
As in other pregnancies, breastfeeding is encouraged as tolerated for the preterm infant. Milk expression using a breast pump is also encouraged. Extensive counseling should be provided regarding the rate of recurrence of PTB and future management in pregnancy. Treatment with antibiotics before pregnancy does not prevent recurrent PTB. In women with a prior spontaneous PTB <34 weeks, oral azithromycin and metronidazole every 4 months after the PTB and before the next conception does not significantly reduce subsequent PTB [87]. Vaginal and IM progesterone has been shown to reduce the risk of recurrent PTB and adverse perinatal outcomes in women with a history of spontaneous singleton PTB. Following spontaneous singleton PTB, women should be counseled about the benefits of progesterone prophylaxis in subsequent pregnancies [88]. (See also Chap. 18.)
Breastfeeding complications
Published in Amy Brown, Wendy Jones, A Guide to Supporting Breastfeeding for the Medical Profession, 2019
Sometimes a mother may be encouraged to use a breast pump in addition to feeding directly at the breast. Hospital-grade double pumps can be rented to help make the pumping sessions more time-efficient and mothers can use hands-on pumping techniques to increase output, which includes breast massage prior to pumping, compressing and massaging during the main pumping session and hand expression afterwards.
The breast
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
This may occur during lactation and be the forerunner of acute infective mastitis. If the nipple becomes cracked during lactation, it should be rested for 24-48 hours and the breast should be emptied with a breast pump. Feeding should be resumed as soon as possible.
Exclusive Breastfeeding and Migrant Mothers’ Agency in Chile
Published in Women's Reproductive Health, 2023
Second, the narrative also emphasized that, given the required demand, the breast pump plays an important role in giving her the possibility of doing other activities without her baby. The ChCC Program documents mention the use of breast pumps, referring to them as not as effective as the direct suction of the breast and not mentioning the benefits, such as free time (Strain et al., 2017). In some cases, health professionals interfered with institutional guidelines: Interviewer: The midwife (…) did she tell you why (not to use the breast pump)?Juana: No, she did not say anything. She just told me, “No.” No, OK, she did tell me that the majority of the, how is the name? The breast pump, if they are not washed well, the fungus can come out, and she made me understand that he did not like them, that he had to wash them well. I sterilize them, of course. I also looked online because they did not even tell me, “Well, you have to sterilize it.” They did not even ask me if I sterilized it, she did not even ask me how I washed it, you know? Nothing (Juana). The midwife’s disagreement was related to the encouraged type of breastfeeding, where the technique for direct breastfeeding is controlled in the first clinical visit.
Infant sex differences in human milk intake and composition from 1- to 3-month post-delivery in a healthy United States cohort
Published in Annals of Human Biology, 2021
Erin K. Eckart, Jennifer D. Peck, Elyse O. Kharbanda, Emily M. Nagel, David A. Fields, Ellen W. Demerath
Mothers and infants visited the centres for follow-up at 1-month [median (25th and 75th) = 31.0 (28.0, 34.0) d] and 3-month postpartum [median (25th and 75th) = 92.0 (88.0 and 95.0) d]. Mothers were instructed to come to the test centre for a morning feeding, followed by completion of questionnaires and a collection of a milk sample. Upon arrival between 8:00 and 10:00 am, infants were weighed without clothing but including a fresh diaper on a high sensitivity weighing scale integrated into the Pea Pod (accuracy ± 2 g) (Ma et al. 2004), and then mothers were asked to feed their infant ad libitum from one or both breasts until their infant was satisfied, followed by a second weighing of the infant after the feeding, again without clothing but with the same diaper to insure that any expelled urine or faeces were included in the weights. The difference in post-feeding weight and pre-feeding weight (in grams) was determined for each infant at the 1- and 3-month visits. The test weighing method of assessing infant milk intake has been shown to be highly accurate and precise (Meier et al. 1990). The milk sample was collected at a standardised time, 2 h after the test feeding. Mothers were asked to express the entire contents of the right breast using a hospital-grade electric breast pump (Medela SymphonyTM; Medela Inc., McHenry, IL). Within 20 min of collection, the milk sample was mixed, aliquoted, and stored at −80 °C.
Origins of human milk microbiota: new evidence and arising questions
Published in Gut Microbes, 2020
Shirin Moossavi, Meghan B. Azad
Although our study was not specifically designed to assess the effect of pumping, we compared milk from mothers who sometimes used a breast pump to express milk for their infant (at least once in the 2 weeks prior to sample collection) to those who did not feed pumped milk to their infant. Although we did not document nursing frequency, it is reasonable to assume it was lower among mothers who pumped; thus, one could argue that we actually (or also) assessed the impact of less vs. more direct exposure to the infant oral cavity. In other words, our results could reflect an increased exposure to pumps and/or a decreased exposure to the infant mouth. Either way, we observed that the bacterial diversity and composition were slightly different between these two scenarios, providing some evidence for the role of retrograde (exogenous) milk inoculation.