Journal article
Effect of nipple shield use on milk removal: A mechanistic study
BMC Pregnancy and Childbirth, Vol.20(1), Art. 516
2020
Abstract
Background
Concerns about reduced milk transfer with nipple shield (NS) use are based on evidence from studies with methodological flaws. Milk removal during breastfeeding can be impacted by infant and maternal factors other than NS use. The aim of this study was to control electric breast pump vacuum strength, pattern and duration across multiple study sessions to determine if NS use reduces milk removal from the breast.
Methods
A within-subject study with two groups of breastfeeding mothers (infants < 6 months) were recruited; Control Group (CG): no breastfeeding difficulties; Pain Group (PG) used NS for persistent nipple pain. Mothers completed three randomised 15 min pumping sessions using the Symphony vacuum curve (Medela AG); no NS, fitted NS, and a small NS. Sessions were considered valid where the applied vacuum was within 20 mmHg of the set vacuum. Milk removal was considered as pumped milk volume, and also percentage of available milk removed (PAMR), which is calculated as the pumped volume divided by the estimated milk volume stored in the breast immediately prior to pumping.
Results
Of 62 sessions (all: n = 31 paired sessions) a total of 11 paired sessions from both PG (n = 03) and CG (n = 08) were valid (subset) with and without a fitted NS. Only 2 small shield sessions were valid and so all small shield measurements were excluded. Both pumped volumes and PAMR were significantly lower with NS use for all data but not for subset data. (All: Volume and PAMR median: no NS: 76.5 mL, 69%, Fitted NS: 32.1 mL, 41% respectively (volume p = 0.002, PAMR p = 0.002); Subset: Volume and PAMR median: no NS: 83.8 mL, 72%; Fitted NS: 35.2 mL, 40% (volume p = 0.111 and PAMR p = 0.045). The difference in PAMR, but not volume, was statistically significant when analysed by linear mixed modelling. A decrease of 10 mmHg was associated with a 4.4% increase in PAMR (p = 0.017).
Conclusions
This experimental data suggests that nipple shield use may reduce milk removal. Close clinical monitoring of breastfeeding mothers using nipple shields is warranted.
Details
- Title
- Effect of nipple shield use on milk removal: A mechanistic study
- Authors/Creators
- V.S. Coentro (Author/Creator) - The University of Western AustraliaS.L. Perrella (Author/Creator) - The University of Western AustraliaC.T. Lai (Author/Creator) - The University of Western AustraliaA. Rea (Author/Creator) - Murdoch UniversityK. Murray (Author/Creator) - The University of Western AustraliaD.T. Geddes (Author/Creator) - The University of Western Australia
- Publication Details
- BMC Pregnancy and Childbirth, Vol.20(1), Art. 516
- Publisher
- BioMed Central
- Identifiers
- 991005543791407891
- Murdoch Affiliation
- Information Technology, Mathematics and Statistics
- Language
- English
- Resource Type
- Journal article
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- Citation topics
- 1 Clinical & Life Sciences
- 1.72 Obstetrics & Gynecology
- 1.72.891 Breastfeeding
- Web Of Science research areas
- Obstetrics & Gynecology
- ESI research areas
- Clinical Medicine