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.

中文翻译：

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手挤母乳与乳房按摩的时间与早产儿母亲标准护理的比较：使用随机对照设计的探索性试验

背景：在全球范围内，所有新生儿中有 10% 是早产儿。需要通过人工挤奶来获取母乳，以减少与早产相关的不良后果的发生率。然而，几乎没有证据可以推荐早产儿母亲开始吸乳的最佳时机或最有效的方法。研究目的：(1) 测试招募和遵守方案的可行性，以及 (2) 确定使用手部挤压和乳房按摩对 3 个月时产奶量、充血、乳腺炎和母乳喂养状态的影响。方法：本研究是一项探索性平行两组试验性随机对照试验。澳大利亚昆士兰州大都会妇产医院早产儿的妈妈们（N= 31) 被随机分配在出生后 1 小时内接受手动挤奶和乳房按摩，或在出生后 6 小时内接受标准护理、手动挤奶，以确定对 3 个月时产奶量、充血、乳腺炎和母乳喂养状态的影响。结果：可行性指标没有达到；然而，从该试验中获得的宝贵经验揭示了助产士在出生后 1 小时开始吸乳时面临的障碍。尽管趋势支持未来的研究，但次要结果的发生率没有差异。结论：总体而言，早产的不可预测性影响了我们招募参与者的能力。未来研究设计的重要方向将受益于将最多 6 小时的吸乳时间与可复制的乳房按摩相结合。