STUDY OBJECTIVE To compare breast milk volume between manual breast milk expression and breast pump expression among mothers of term infants with poor latch or poor suck at different time points on postnatal day 2 day 3 and day 4
STUDY DESIGN Randomized controlled trial
STUDY SETTING Postnatal ward of a tertiary care hospital
INCLUSION CRITERIA Mothers of term infants equal to or more than 37 weeks gestation Infants with poor latch or poor suck Poor latch or poor suck determined by maternal interview review of lactation consultation and assessment by a study doctor or nurse
EXCLUSION CRITERIA Mother age less than 18 years History of breast surgery other than cyst removal Infants with gestational age less than 37 weeks Birth weight less than 2500 g
RANDOMIZATION Eligible mother infant less than 7days were randomly assigned to one of two groups Manual expression group Pump expression group
INTERVENTIONS
PRE INTERVENTION PROCEDURE Initial infant weight recorded using the same weighing scale Mothers attempted breastfeeding with advice and support from a study doctor or nurse
MANUAL EXPRESSION GROUP Mothers were taught Marmet hand expression technique Hand expression performed for 15 minutes in a single supervised session
PUMP EXPRESSION GROUP Mothers were taught breast pumping technique Bilateral electric breast pump used for 15 minutes in a single supervised session Vacuum setting started at 30 mm Hg and gradually increased as tolerated
OUTCOME MEASURES Expressed breast milk volume measured after expression Cumulative milk volume calculated All expressed milk measured using a syringe Expressed milk fed to infants using syringe cup or spoon Infants reweighed on the same scale after feeding
QUESTIONNAIRES Breastfeeding confidence assessment Breastfeeding related pain assessed in breast lower abdomen back and perineum on a scale of 0 to 10 Assessment of social support for milk expression Assessment of personal and learning experience of milk expression
FOLLOW UP Phone follow up at 2 weeks 1 month and 2 months Assessment of breastfeeding milk expression and formula use |