Introduction: 

Mother's own milk improves health outcomes in infants of all gestational ages. Although pump-dependent mothers of extremely premature infants are at risk of insufficient milk production, whether mother's milk production is impacted by gestational age and pump dependency in mothers of more mature critically ill infants is unknown.

Purpose: 

To determine whether there is a relationship between gestational age, milk production, and time to secretory activation in mothers delivering a critically ill infant.

Methods: 

A convenience sample of 136 pump-dependent mothers whose infants were admitted to the neonatal intensive care unit was enrolled between 2013 and 2016 as part of a quality improvement project. Group 1 (early preterm) delivered infants at 30 to 33 weeks of gestation (n = 41), group 2 (late preterm) 34 to 36 weeks (n = 48), and group 3 (term) 37 weeks and more (n = 47). Milk volume on days 1 to 7 was measured by weighing each vial of expressed milk and compared using general linear mixed-model analysis. Time to the onset of secretory activation was compared using censored regression analysis.

Results: 

Main effect for gestational age controlling for day was statistically significant (P = .0234). The early preterm group produced more milk over the 7-day study than the term (P = .01) and late preterm (P = .02) groups. The early preterm group achieved secretory activation earlier than the late preterm group (adjusted P = .039).

Implications for Practice: 

Pump-dependent mothers of all infants admitted to the neonatal intensive care unit may be at risk of inadequate milk production and delayed secretory activation and may therefore benefit from early milk production monitoring and lactation support.

Implications for Research: 

Further studies should examine targeted interventions to increase milk production in pump-dependent mothers.

中文翻译：

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重症婴儿依赖泵的母亲的奶量结果

介绍： 

母乳可以改善所有胎龄婴儿的健康状况。尽管极度早产儿依赖泵的母亲存在产奶量不足的风险，但母亲的产奶量是否受胎龄和更成熟危重婴儿母亲的泵依赖的影响尚不清楚。

目的： 

确定分娩危重婴儿的母亲的胎龄、产奶量和分泌激活时间之间是否存在关系。

方法： 

作为质量改进项目的一部分，在 2013 年至 2016 年间招募了 136 名依赖泵的母亲的便利样本，这些母亲的婴儿入住新生儿重症监护室。第 1 组（早期早产）在妊娠 30 至 33 周（n = 41）分娩，第 2 组（晚期早产）在 34 至 36 周（n = 48）和第 3 组（足月）37 周及以上（n = 47)。第 1 至 7 天的奶量通过称量每瓶挤出的奶来测量，并使用一般线性混合模型分析进行比较。使用审查回归分析比较分泌激活开始的时间。

结果： 

控制天数的胎龄主效应具有统计学意义（P = .0234）。在为期 7 天的研究中，早期早产组比足月组 ( P = .01) 和晚期早产组 ( P = .02) 产奶量更多。早期早产组比晚期早产组更早实现分泌激活（调整后的P = .039）。

对实践的影响： 

所有入住新生儿重症监护病房的婴儿依赖泵的母亲可能存在产奶量不足和分泌激活延迟的风险，因此可能受益于早期产奶量监测和哺乳支持。

对研究的影响： 

进一步的研究应检查有针对性的干预措施，以增加依赖泵的母亲的产奶量。