The Trajectory of Expressed Colostrum Volume in the First 48 Hours Postpartum: An Observational Study
The Trajectory of Expressed Colostrum Volume in the First 48 Hours Postpartum: An Observational Study
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DOI：
10.1089/bfm.2020.0366
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发表时间：
2021-09-16
影响因子：
2.7
通讯作者：
Kusaka, Takashi
中科院分区：
文献类型：
--
作者：
Kato, Ikuko;Horike, Kimiyo;Kusaka, Takashi
目的：初乳是母乳的第一种形式，由于其益处而被强烈鼓励用于婴儿。在产后早期（PP）期间，分泌的初乳量可能很小，导致母亲担心乳汁供应不足。很少有研究检查初乳的时间变化。本研究旨在阐明分娩后最初48小时内表达的初乳体积的轨迹。材料和方法：这是一项在香川国立儿童医院进行的横断面观察性研究。105名在分娩后48小时内没有直接母乳喂养的母亲参加了这项研究。训练有素的助产士指导母亲如何挤出母乳，母亲们在分娩后尽快开始挤出母乳。建议母亲每3小时挤出一次母乳，并测量母乳量。结果如下：在PP的3小时内，60%的母亲表达乳汁，并且在前48小时内表达的中位频率为14次（四分位数范围，11-16）。在PP 0-3和3-6小时，最初挤出的乳汁体积分别为0.4（0.0-2.0）mL和1.0（0.0-6.0）mL。随后，奶量下降。量保持低，直到30小时PP和显着增加，这种现象被称为分泌激活，开始在初产妇比在多产妇女。结论：PP早期的挤出奶量下降引起了母亲的关注。因此，应告知母亲母乳量的PP轨迹。
Objective: Colostrum, the first form of human milk, is strongly encouraged for infants due to its benefits. During the early postpartum (PP) period, the secreted colostrum volume can be minimal, causing concerns among mothers about sufficient milk supply. Few studies have examined temporal changes in the colostrum. This study aimed to elucidate the trajectory of expressed colostrum volume in the first 48 hours after delivery. Materials and Methods: This was a cross-sectional observational study performed at Kagawa National Children's Hospital. One hundred five mothers who did not directly breastfeed in the first 48 hours after delivery were enrolled in the study. Well-trained midwives instructed the mothers on how to express human milk, and mothers started to express as soon as possible after delivery. Mothers were advised to express human milk every 3 hours, and the milk volume was measured. Results: Within 3 hours PP, 60% of mothers expressed milk, and the median frequency of expression was 14 (interquartile range, 11-16) times in the first 48 hours. At 0-3 and 3-6 hours PP, the volume of initially expressed milk was 0.4 (0.0-2.0) mL and 1.0 (0.0-6.0) mL, respectively. Subsequently, milk volume decreased. The volume remained low until 30 hours PP and increased dramatically; this phenomenon is termed secretory activation, which began later in primiparous women than in multiparous women. Conclusion: The decline in expressed milk volume during the early PP period caused concern among mothers. Therefore, mothers should be informed of the PP trajectory of human milk volume.