title: Volume of milk obtained in relation to location and circumstances of expression in mothers of very low birth weight infants.
abstract: BACKGROUND
  Given the importance of mother's milk for very low birth weight (VLBW) infants, it would be helpful to know which circumstances are most favorable for milk expression.
  
  
  OBJECTIVE
  This study aimed to estimate the volume of milk obtained by mothers of VLBW infants as a function of proximity to the infant and use of the kangaroo position during the actual expression.
  
  
  METHODS
  In this prospective cohort study, when the infant was stable and the mother had established a breastfeeding routine, she was given a notebook in which to record the location of expression and the amount of milk expressed for 10 consecutive days. Breast milk expression volumes were recorded and analyzed.
  
  
  RESULTS
  Data were collected on 26 mother-VLBW infant dyads and 1642 milk expressions. The first early morning expressions (n = 276, 17%) were conducted at home. Thereafter, 743 (45%) expressions were conducted far from the infant, either in a different room within the hospital or at home, and 623 (38%) were performed in proximity to the infant (beside the incubator, during kangaroo mother care [KMC], after KMC, or during kangaroo father care). The mean milk volume was significantly higher when expression was conducted in proximity to the infant. When only milk expressions conducted in proximity to the infant were considered, volumes obtained during KMC (107.7 mL, 91.8-123.5) and after KMC (117.7 mL, 99.0-136.5) were significantly higher than those obtained beside the incubator (96.9 mL, 79.9-113.9), respectively, P = .0030 and P = .0024.
  
  
  CONCLUSIONS
  Milk expression conducted in proximity to the infant, particularly during and immediately after KMC, is associated with higher milk volume.
authors.affiliation: 1Department of Neonatology, 12 de Octubre University Hospital, Madrid, Spain.
authors.forename: Juliana
authors.initials: J
authors.lastname: Acuña-Muga
authors.forename: Noelia
authors.initials: N
authors.lastname: Ureta-Velasco
authors.forename: Javier
authors.initials: J
authors.lastname: de la Cruz-Bértolo
authors.forename: Rosa
authors.initials: R
authors.lastname: Ballesteros-López
authors.forename: Rocío
authors.initials: R
authors.lastname: Sánchez-Martínez
authors.forename: Eugenia
authors.initials: E
authors.lastname: Miranda-Casabona
authors.forename: Almudena
authors.initials: A
authors.lastname: Miguel-Trigoso
authors.forename: Lidia
authors.initials: L
authors.lastname: García-San José
authors.forename: Carmen
authors.initials: C
authors.lastname: Pallás-Alonso
mesh_terms: D000328:Adult; D061186:Breast Milk Expression / Q000379:methods* / Q000523:psychology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D060127:Kangaroo-Mother Care Method / Q000379:methods* / Q000523:psychology; D007774:Lactation / Q000502:physiology* / Q000523:psychology; D008895:Milk, Human; D009034:Mother-Child Relations; D011446:Prospective Studies
keywords: breast pumping; breastfeeding; kangaroo mother care; milk expression; milk production; very low birth weight infants