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1.
Midwifery ; 136: 104039, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38909553

ABSTRACT

PROBLEM: Breast pumping practices have scope for improvement. BACKGROUND: Breast milk weight measurement can be used to evaluate milk flow pattern dynamics during breast pumping. AIM: To determine inter-individual differences in milk flow patterns and their practical implications based on high milk flow rate period (HFP) data among Japanese women expressing breast milk using an electric pump. METHODS: This cross-sectional, observational study analysed data from 19 women (33.0 ± 3.9 years) nursing 1-6-month-old infants and with previous breast milk expression experience. Breast milk was weighed continuously during a 15-min single-breast electric pumping session. The HFP features and flow rate time (≥0.1 g/s) were analysed to determine each individual's milk flow pattern. FINDINGS: The total expressed breast milk was 69.8 ± 42.5 g with a maximum individual flow rate of 0.5 ± 0.2 g/s. The breast milk yielded during the HFPs was 43.1 (34.4-81.3) g, accounting for 82.5 % (69.9-89.5 %) of the total expressed breast milk. HFP occurred 0-3 times during the 15-min session. Multiple discrete and continuous milk flow patterns were observed. Among those with discrete HFP, the HFP interval was 221 (68-371) s. Breast milk fat content changes and subjective residual milk measurements implied sufficient milk removal. A strong positive correlation was noted between HFP length and total breast milk expression volume. DISCUSSION: Individual differences in milk flow patterns were observed among the women using HFP. Milk flow patterns were consistent with previous reports. CONCLUSION: Milk flow pattern data can be used to guide individualised lactation support.


Subject(s)
Breast Milk Expression , Milk, Human , Humans , Female , Cross-Sectional Studies , Breast Milk Expression/methods , Breast Milk Expression/instrumentation , Breast Milk Expression/statistics & numerical data , Adult , Japan , Milk Ejection/physiology , Infant, Newborn , Lactation/physiology
2.
J Dairy Sci ; 107(8): 6322-6329, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38608941

ABSTRACT

Milk ejection disorders were induced by oxytocin receptor blockade. We tested the hypothesis that the degree of udder emptying at incomplete milk ejection can be estimated based on the concentration of various milk constituents in different milk fraction samples. To induce different levels of spontaneous udder emptying (SUE) 10 Holstein dairy cows were milked either with or without i.v. injection of the oxytocin receptor blocking agent atosiban (ATO). In ATOearly, 12 µg/kg BW ATO was injected immediately before and in ATOlate directly after a 1-min manual udder preparation. The normal milking routine served as the control treatment. In all 3 treatments the udder was completely emptied by the i.v. injection of 10 IU oxytocin (OT) at the end of spontaneous milk flow. During all experimental milkings 4 milk samples were taken in all treatments: at the start of udder preparation (foremilk; FM), immediately after cessation of spontaneous milk flow and cluster detachment by hand stripping (strip milk; SM), from spontaneous removed milk in bucket 1 (milk before OT; MBOT) and from the milk obtained after OT injection in bucket 2 (milk after OT; MAOT). Fat, protein, lactose, and electrolytes (Na, Cl, and K) were measured in each milk sample. In addition, electrical conductivity (EC) was determined in parallel to continuous milk flow recording. The treatments induced individual degrees of SUE; therefore, the final evaluations of data were based on SUE classes instead of treatments. The most pronounced differences of milk constituents at different degrees of SUE were found for the milk fat content. The fat content of SM and MBOT remained almost unchanged up to 60% SUE, but was considerably higher if >80% of the milk was spontaneously removed. The concentrations of Na and Cl were highest and of K lowest if less than 20% of milk was received in the different samples. The EC was higher in SM and MBOT if <20% of milk was received. In conclusion, the blockade of the OT effect influences primarily the fat content, which confirmed an OT-induced fat secretion during milking. Similar effects are likely found in situations of disturbed milk ejections, caused by a lack of or reduced release of OT in response to different degrees of tactile udder stimulation. Our results show that the measurement of fat content and the EC in SM samples collected after cluster detachment can be used to estimate the completeness of udder emptying.


Subject(s)
Lactation , Mammary Glands, Animal , Milk , Oxytocin , Animals , Milk/chemistry , Female , Cattle , Oxytocin/pharmacology , Oxytocin/analysis , Milk Ejection , Dairying
3.
Breastfeed Med ; 19(7): 547-553, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38647520

ABSTRACT

Objective: Postpartum mental health, significantly influences breastfeeding. Dysphoric milk ejection reflex (D-MER) is defined as negative emotional reaction to milk ejection, such as unpleasant feelings, anger-irritability or a strange feeling in the stomach. This study investigates the impacts of D-MER on mothers experiencing negative emotions during breastfeeding. Method: This cross-sectional, descriptive study was conducted between July 1 and September 30, 2023 among surveyed mothers with babies of ages 0-2 experiencing discomfort while breastfeeding. Mothers reached out through Instagram and Facebook and completed a semi-structured 45-question survey using a Google form. Results: Out of 141 mothers, 27.7% (n: 39) had D-MER findings. Common emotions included tension (48%), exhaustion (43%), intolerance (41%), hypersensitivity (35%), and restlessness (33%). Symptoms reported to begin within the first month of breastfeeding in 59% of D-MER cases. Nausea was reported in 30% of mothers. The most common conditions that increased the severity of D-MER symptoms were insomnia, stress and breast fullness. Sleeping or resting, being alone, doing something else, drinking cold water, listening to music and talking to mothers who had similar experiences helped the mothers relax. In cases with D-MER findings, about 17.9% considered stopping breastfeeding, with 7.7% stopping. The postpartum depression score was ≥13 in 59% of D-MER cases. Conclusion: D-MER, which can cause early cessation of breastfeeding, may also be associated with the mother's mental health problems. Raising awareness about D-MER and equipping health professionals on this subject are important in the continuity of breastfeeding.


Subject(s)
Breast Feeding , Mental Health , Milk Ejection , Mothers , Humans , Female , Cross-Sectional Studies , Breast Feeding/psychology , Adult , Mothers/psychology , Infant, Newborn , Milk Ejection/physiology , Infant , Postpartum Period/psychology , Surveys and Questionnaires
4.
Breastfeed Med ; 19(6): 467-475, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38587274

ABSTRACT

Background: Dysphoric milk ejection reflex (D-MER) is a phenomenon that occurs before milk letdown and is described as a wave of negative or devastating emotions, ranging from mild to severe and lasting for seconds to minutes. To date, there has been little research regarding this phenomenon. This study aims to determine the prevalence of D-MER in our population as well as its association with postnatal depression scores and breastfeeding self-efficacy. Methods: Lactating persons between 4 and 12 weeks postpartum at our institution were invited to complete an anonymous 59-question survey via an online platform. Questions asked included patient demographics, presence of symptoms of dysphoria (including timing, duration, and frequency), the Edinburgh Postnatal Depression Scale (EPDS), and the Breastfeeding Self-Efficacy Scale Short Form (BSES-sf). Results: In total, 201 women completed the survey. Twelve women were classified as likely having D-MER (6%). Symptom resolution primarily occurred within a minute to 5 minutes (58%). Mean EPDS scores differed significantly between those with likely D-MER and those without (12.2 vs. 5.4, p = 0.002). BSES-sf scores differed significantly between the two groups (43.1 vs. 52.5, p = 0.009). Preexisting depression or anxiety was not associated with D-MER (p = 0.133), other reported mood disorders differed significantly between those with D-MER and those without (p = 0.004). Demographic characteristics of women with and without D-MER were similar. Conclusion: D-MER prevalence may be lower than previously reported. Patients with likely D-MER appear to have lower breastfeeding self-efficacy and higher depression scores. Those with preexisting mood disorders may be at higher risk of experiencing D-MER.


Subject(s)
Breast Feeding , Depression, Postpartum , Milk Ejection , Self Efficacy , Humans , Female , Breast Feeding/psychology , Adult , Risk Factors , Depression, Postpartum/epidemiology , Depression, Postpartum/psychology , Milk Ejection/physiology , Surveys and Questionnaires , Prevalence , Lactation/psychology , Mothers/psychology , Psychiatric Status Rating Scales , Postpartum Period/psychology
5.
Arch Gynecol Obstet ; 310(1): 627-630, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38676742

ABSTRACT

Dysphoric milk ejection reflex is a condition that causes an abrupt emotional downturn during the initial moments of milk ejection in a breastfeeding mother. Depression, anxiety, hopelessness, anger, irritability, homesickness, and stomach hollowness are all possible symptoms. The exact cause of D-MER remains unknown. However, it is proposed that it is caused by an alteration in oxytocin signaling response where secretion of oxytocin upregulates the stress response instead of its downregulation. Activation of the defensive response of the mother by oxytocin during breastfeeding, disruption in dopamine levels, and activation of vasopressin-regulated pathways are other probable causes. Due to a lack of awareness, this phenomenon is easily misdiagnosed as postpartum depression and aversion by many healthcare professionals. Its prevalence in various populations of the world remains unknown due to the lack of research studies conducted in these populations. While no medically approved therapeutic strategy is available, supportive techniques such as maintaining a healthy diet, mental distraction, relaxation methods, and increasing skin-to-skin contact can help alleviate dysphoria during breastfeeding. However, due to a lack of D-MER research, specific challenges exist regarding early withdrawal from breastfeeding and women's help-seeking attitude toward perinatal mental health.


Subject(s)
Breast Feeding , Depression, Postpartum , Milk Ejection , Oxytocin , Female , Humans , Breast Feeding/psychology , Depression, Postpartum/physiopathology , Depression, Postpartum/diagnosis , Depression, Postpartum/psychology , Milk Ejection/physiology
6.
J Dairy Sci ; 107(8): 6278-6287, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38490544

ABSTRACT

Our objectives were to investigate the association of teat shape with (1) bimodality, (2) incremental milk flow rates (average flow rates during the first 15 s, 15-30 s, 30-60 s, and 60-120 s of milking), and (3) peak milk flow rate in Holstein dairy cows milked 3 times/d. In this prospective cohort study, we analyzed 220,928 milking observations that were collected from 2,520 cows from a single dairy herd over a period of 31 d. Teat shape was visually assessed and classified into 1 of 4 categories as follows: (1) triangular barrel and pointed teat end (TP), (2) square barrel and round teat end (SR), (3) square barrel, round teat end, and flat in the area of the teat orifice (SRF), and (4) square barrel and flat teat end (SF). Individual cow-level milk flow rates were obtained using electronic on-farm milk meters. We considered bimodality to be present if any of the incremental milk flow rates (flow rates during 15-30 s, 30-60 s, or 60-120 s) were lower than any of the previous rates (flow rates during the first 15 s, 15-30 s, or 30-60 s). The frequency distribution of cows with different teat shapes was as follows: TP, 96 (3.8%); SR, 1,751 (69.5%); SRF, 617 (24.5%); and SF, 56 (2.2%). A generalized linear mixed model revealed differences in the odds of bimodality among cows with different teat shapes. Compared with cows in category SR, the odds (95% CI) of bimodality of cows in other categories were as follows: TP, 0.68 (0.48-0.97); SF, 1.96 (1.21-3.19); and SRF, 1.46 (1.23-1.72). General linear mixed models indicated an association between teat shape and all incremental milk flow rates, with higher milk flow rates being present for cows with teat shapes in the SRF and SF categories. The general linear mixed model for the dependent variable peak milk flow rate indicated an association between teat shape and peak milk flow rate. Least squares means and 95% CI were 5.1 (4.9-5.3) kg/min for TP, 5.8 (5.5-6.1) kg/min for SF, 5.6 (5.5-5.7) for SRF, and 5.3 (5.3-5.4) for SR, respectively. We conclude that in this study cohort, bimodality is more likely to occur in cows with flat teat ends compared with those with a round teat ends. We attribute this relationship to the difference in milking speed across cows with different teat shapes. Teat shape may serve as a useful phenotype to identify cows that are more likely to exhibit bimodality. Because our study population was unique, future studies considering different circumstances such as breed, milking system, and milking routine are needed before results can be extrapolated.


Subject(s)
Lactation , Mammary Glands, Animal , Milk , Animals , Cattle/physiology , Female , Mammary Glands, Animal/anatomy & histology , Mammary Glands, Animal/physiology , Lactation/physiology , Prospective Studies , Milk Ejection/physiology , Dairying
7.
Int Breastfeed J ; 19(1): 21, 2024 Mar 27.
Article in English | MEDLINE | ID: mdl-38539175

ABSTRACT

BACKGROUND: The dysphoric milk ejection reflex (D-MER) is a reflex that causes temporary discomfort during milk ejection. D-MER develops due to the effects of hormones involved in lactation, and it has been reported that it is a physiological symptom different from postpartum depression, but the actual situation is unknown in Japan. METHODS: This study was conducted using a self-administered, anonymous survey of mothers of children who had undergone health checkups at three years of age at five health centers in Kagoshima city and aimed to clarify the reality and perceptions of mothers regarding D-MER. The survey period was from May to September, 2022. The questionnaires were distributed to 389 mothers, and 216 (55.5% recovery rate) responses were received, of which 202 (valid response rate 93.5%) were included in the analysis. RESULTS: Regarding the experience of D-MER, 202 mothers in the study population had given birth to a total of 403 children and experienced D-MER when breastfeeding 62 children (15.4%). Of the 202 mothers included in the analysis, 47 (23.3%) answered that they had experienced D-MER with at least one child while breastfeeding. Sixty-six mothers (32.7%) knew about D-MER. Compared to those who had not experienced D-MER, those who had experienced D-MER had significantly higher scores on the items related to having had trouble breastfeeding (odds ratio (OR]: 3.78; 95% confidence interval (CI]: 1.57, 9.09) and knowing about D-MER (OR 2.41; 95% CI 1.20, 4.84). Regarding symptoms, irritability (n = 24, 51.1%), anxiety (n = 22, 46.8%), and sadness (n = 18, 38.3%) ranked high. Coping strategies included distraction, focusing on the child, and, in some cases, cessation of breastfeeding. Thirty mothers (63.8%) answered that they did not consult anyone, citing reasons such as a belief that no one would be likely to understand their symptoms, and that they could not sufficiently explain their symptoms. CONCLUSION: The low level of awareness of D-MER suggests that it is necessary to inform and educate mothers and the public about the physiological symptoms of D-MER. Moreover, it is necessary to listen to the feelings of mothers with D-MER and support them in coping with their symptoms.


Subject(s)
Breast Feeding , Milk Ejection , Female , Child , Humans , Milk Ejection/physiology , Japan , Surveys and Questionnaires , Reflex/physiology
8.
J Hum Lact ; 40(2): 237-247, 2024 05.
Article in English | MEDLINE | ID: mdl-38389306

ABSTRACT

BACKGROUND: Dysphoric Milk Ejection Reflex is an understudied condition of lactation involving emotional dysregulation during letdown or milk ejection. Affected individuals may experience transient feelings of helplessness, melancholy, and general unhappiness. RESEARCH AIM: To evaluate the scope of published literature on Dysphoric Milk Ejection Reflex. METHOD: Whittemore and Knafl's methodology guided this integrative review. Five databases were searched for primary research, summaries, and editorials on Dysphoric Milk Ejection Reflex in lactating individuals. Literature searched also included websites, pamphlets, and conference proceedings via Google and Google Scholar. A total of 11 articles, from five different countries, met inclusion criteria for review. RESULTS: Studies on Dysphoric Milk Ejection Reflex and negative emotional sensations during lactation were synthesized under five conceptual umbrellas: (1) Experiences, Sensations, and Symptom Management; (2) Biological Underpinnings; (3) Influence on Maternal Role and Breastfeeding Self-Efficacy; (4) Support, Understanding, and Awareness; and (5) Reduction and Cessation of Breastfeeding. CONCLUSION: Dysphoric Milk Ejection Reflex is a neurobiological condition characterized by low mood and negative feelings during milk ejection throughout lactation. Dysphoric Milk Ejection Reflex is linked to maternal psychological distress and breastfeeding discontinuation. Priority areas for future research include biological origins and interventions aimed at prevention, symptom control, and greater awareness of the condition on a more international scope.


Subject(s)
Lactation , Milk Ejection , Female , Humans , Lactation/psychology , Milk Ejection/physiology , Breast Feeding/psychology , Reflex/physiology
9.
J Dairy Sci ; 107(2): 944-955, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37730177

ABSTRACT

This controlled study compared the effects of 2 different gradual debonding strategies on machine milk yield, flow, and composition in a cow-driven cow-calf contact (CCC) system with automatic milking. Cows had 24 h/d access to their calves during the first weeks of lactation. In the long debonding (LDB) treatment (n = 16), a gradual reduction of cows' access to their calves was initiated 4 wk after calving over a total period of 28 d; first to 12 h/d (14 d), and then to 6 h/d (14 d). In the short debonding (SDB) treatment (n = 14), gradual reduction was initiated 6.5 wk after calving over a total period of 10 d; first to 12 h/d (5 d), and then to 6 h/d (5 d). From 6 h/d, access was finally reduced to 0 h/d for 7 d for both treatments. Machine milk yield, somatic cell count, and peak and average milk flow were automatically registered at milking. During the 9-wk study period, composite samples were analyzed for milk composition. Data were analyzed with linear mixed effect models. Results showed that machine milk yield during 24 h/d access varied between cows (range 1.2-49.9 kg/d, average ± standard deviation 13.2 ± 7.82 kg/d). The LDB cows had a higher daily machine milk yield than SDB cows at the end of and after access reduction was completed (+5.0 ± 1.63 and +5.1 ± 1.55 kg during the last 5 d of 6 h/d access, and 0 h/d access, respectively). Somatic cell count was on a healthy level, with no difference between treatments. Milk fat content increased with reduction in access, regardless of treatment. Short debonding cows tended to show higher milk protein content and lower milk lactose content than cows with a longer debonding. This study has shown that a longer debonding initiated earlier may give a higher milk yield in the short term. The variation in machine milk yield may indicate differences in milk ejection, suckling, and visiting patterns and preferences among cows.


Subject(s)
Lactation , Milk , Female , Cattle , Animals , Milk/metabolism , Milk Proteins/metabolism , Milk Ejection , Dairying/methods
10.
Femina ; 51(12): 674-681, 20231230. ilus
Article in Portuguese | LILACS | ID: biblio-1532470

ABSTRACT

Objetivo: Identificar o conhecimento dos médicos ginecologistas e obstetras do Paraná sobre o reflexo disfórico da ejeção do leite e seus diagnósticos diferenciais. Métodos: Estudo observacional transversal com médicos ginecologistas e obste- tras associados ao Conselho Regional de Medicina do Paraná. A coleta de dados foi realizada por questionário online compreendendo perguntas de identificação do profissional, tempo de formação, conhecimento e experiência com reflexo disfóri- co da ejeção do leite, dificuldades de diferenciação entre os transtornos mentais puerperais, além da abordagem das questões psicológicas puerperais com as pa- cientes. Os resultados foram expressos por frequências e percentuais. Valores de p menores que 0,05 foram considerados significativos. Resultados: Entre os partici- pantes, 39,1% desconhecem o reflexo disfórico da ejeção do leite. Dos profissionais que já fizeram o diagnóstico, 72,4% apresentaram dificuldade em realizá-lo. Houve acerto majoritário em relação ao momento de ocorrência dos sintomas (90,6%) e tempo de duração (90,6%), mas deficiência no reconhecimento de todos os sin- tomas (3,1%), início das manifestações clínicas (12,6%) e tratamento (44%) pelos profissionais que conhecem o reflexo disfórico da ejeção do leite. Entre os especia- listas, 21,5% sentem-se capazes para diferenciar os três distúrbios e 24,1% têm difi- culdade na diferenciação entre as patologias. Apenas 65,5% dos médicos abordam as dificuldades emocionais na amamentação e, segundo 78,1% dos profissionais, poucas pacientes perguntam ou nunca perguntam sobre essas dificuldades. Con- clusão: O reflexo disfórico da ejeção do leite é uma condição pouco conhecida e confundida com outros transtornos mentais puerperais. É necessária maior divul gação sobre o tema entre os ginecologistas e obstetras, a fim de melhorar a assistência às puérperas, refletindo na persistência da amamentação e seus benefícios.


Objective: To identify the knowledge of gynecologists and obstetricians in Paraná about the dysphoric milk ejection re- flex and its differential diagnosis. Methods: Cross-sectional observational study was conducted with gynecologists and obstetricians associated in the Regional Council of Medicine of Paraná. Data collection was dove through an online question- naire with questions about professional identification, years of experience, knowledge and experience with the dysphoric milk ejection reflex, differentiation puerperal mental disorders difficulties, as well as the approach of postpartum psycholo- gical issues with patients. Results were expressed in frequen- cies and percentages. P values less than 0.05 were considered significant. Results: 39.1% of the participants unknown the dysphoric milk ejection reflex. Among the professionals who had diagnosed dysphoric milk ejection reflex, 72.4% reported difficulties in making the diagnosis. There was a high level of correct answers regarding the timing of symptoms (90.6%) and duration (90.6%), but deficiencies were observed in recognizing all symptoms (3.1%), onset of clinical manifestations (12.6%), and treatment (44%) by professionals who were familiar with dysphoric milk ejection reflex. 21.5% of specialists felt capab- le of differentiating between the three disorders, while 24.1% had difficulty in differentiating between the pathologies. Only 65.5% of doctors approach emotional difficulties in breastfee- ding and, according to 78.1% of professionals, few patients ask or never ask about these difficulties. Conclusion: Dysphoric milk ejection reflex is a condition that is poorly known and of- ten confused with other postpartum mental disorders. Greater awareness about this topic is necessary among gynecologists and obstetricians to improve care for postpartum women, lea- ding to the continuation of breastfeeding and its benefits.


Subject(s)
Humans , Male , Female , Health Knowledge, Attitudes, Practice , Depression, Postpartum/diagnosis , Milk Ejection , Puerperal Disorders/diagnosis , Gynecologists , Obstetricians , Mental Disorders/diagnosis
13.
Breastfeed Med ; 18(5): 388-394, 2023 05.
Article in English | MEDLINE | ID: mdl-37022738

ABSTRACT

Background: The symptoms of Dysphoric Milk Ejection Reflex (D-MER) occur just before milk release, last no more than a few minutes, and then subside spontaneously, which are characterized by a sudden and transient feeling of dysphoria, depression, sadness, or other negative emotions. These emotions may adversely affect the mother's lactation behavior and mental health, negatively influence the mother-child relationship, and even result in self-harm or suicidal tendencies in lactating women. Case Presentation: We reported two cases of breastfeeding mothers with D-MER who experienced unpleasant emotions during lactation. Severely affected by D-MER symptoms, the mother in the first case chose to wean prematurely after struggling for 6 months, and her symptoms disappeared after weaning. With the help of professional guidance, the mother with D-MER in the second case actively adjusted and persisted in breastfeeding until her daughter was 18 months old, after that her symptoms vanished. Discussion: Awareness and knowledge of D-MER are insufficient among the public and health care professionals. D-MER is not a psychological disorder but a physiological issue caused by hormones, which is different from postpartum depression. The severity of D-MER symptoms can be evaluated by the assessment tool of the D-MER spectrum. Lactating women can relieve their symptoms through self-regulation, lifestyle changes, and professional guidance and treatments. Conclusions: The two cases studies about Chinese women with D-MER will enrich the knowledge of D-MER, and it might suggest some directions to health care workers for exploring scientific guidance and treatments for lactating women. Because the literature and published empirical studies about D-MER are scarce, further researches on the theory and interventions of D-MER are necessary.


Subject(s)
Lactation , Milk Ejection , Female , Humans , Infant , Milk Ejection/physiology , Lactation/physiology , Breast Feeding/psychology , Mothers/psychology , Reflex/physiology
14.
J Dairy Sci ; 106(5): 3615-3624, 2023 May.
Article in English | MEDLINE | ID: mdl-37002133

ABSTRACT

Efficient machine milking requires an optimal interaction of alveolar milk ejection in the udder and milk removal by the milking machine. The aim of the present study was to test whether the equilibrium between continuous milk ejection and milk removal can also be maintained at very fast milking through a particularly high vacuum. Eight Holstein dairy cows were milked at 42, 52, or 60 kPa, with (PS) or without (nPS) prestimulation. Each of the 6 treatments was conducted at 2 afternoon milkings in each animal. The prestimulation lasted 40 s and consisted of forestripping and teat cleaning. The cluster attachment followed after a 20-s latency period. Throughout each milking, B-mode ultrasound videos of the gland cistern of 1 front quarter as well as milk flow and claw vacuum curves were recorded. Total milk yield was neither affected by nPS or PS nor by the vacuum level. Milk removed within the first minute and the first 2 min of milking and average milk flow were higher, and the duration of incline and time until peak milk flow were shorter at PS than at nPS milkings at all vacuum levels. Machine-on time was shorter at PS than at nPS milkings, although only at 42 and 52 kPa vacuum, obviously caused by the high percentage of bimodalities occurring in nPS milkings (17% bimodalities in PS vs. 92% bimodalities in nPS milkings). The frequency of bimodalities was higher at high than at low vacuum both in PS and nPS milkings. Peak flow rate and average milk flow were both higher at higher vacuum levels. The duration of milk flow plateau was shorter at 60 kPa than at 42 kPa milkings. At the highest vacuum (60 kPa), the shorter plateau phase indicated a declining milk ejection rate toward the end of the plateau phase, and milk ejection could no longer keep up with the fast milk removal; hence, a higher milking efficiency at a higher vacuum level could only be achieved as long as the gland cistern remained sufficiently filled by the continuous milk ejection. The ultrasound imaging confirmed this finding as the duration of cisternal area plateau in the recorded front quarter was shorter at high than at low vacuum. Thus, the highest vacuum of 60 kPa did not cause a shorter machine-on time than 52 kPa. In conclusion, milking at a very high vacuum can increase milking efficiency compared with a low vacuum. However, a vacuum reduction at the start and toward the end of milking is required to prevent overmilking if milking is performed at a very high vacuum.


Subject(s)
Dairying , Milk Ejection , Animals , Cattle , Female , Dairying/instrumentation , Dairying/methods , Mammary Glands, Animal/physiology , Milk Ejection/physiology , Vacuum , Physical Stimulation
15.
Int J Ment Health Nurs ; 32(2): 620-626, 2023 Apr.
Article in English | MEDLINE | ID: mdl-36705232

ABSTRACT

Dysphoric milk ejection reflect (D-MER) is a dysphoria which women may experience within seconds of commencing breastfeeding. It is only recently gaining recognition in the academic literature and may have important implications for breastfeeding continuation, differential diagnosis and perinatal mental health. This perspective piece introduces the topic, sets out the physiological processes underpinning the experience and outlines why increased awareness of D-MER is important for the profession of mental health nursing.


Subject(s)
Milk Ejection , Psychiatric Nursing , Pregnancy , Female , Humans , Milk Ejection/physiology , Lactation/physiology , Lactation/psychology , Breast Feeding/psychology , Reflex/physiology
16.
Physiol Behav ; 258: 114011, 2023 01 01.
Article in English | MEDLINE | ID: mdl-36323376

ABSTRACT

Sleep deprivation is a feature shared by most studied mammals at some point during the postpartum period. Unlike the rabbit, the pig, or the human mother, sleep has been claimed as an essential state for milk ejection in mother rats, where sleep deprivation using gentle handling (GH) prevents milk ejection and pup weight gain. Though sleep deprivation is a stressful situation itself, most common methodologies used in laboratory animals, including GH, usually involve aversive stimulus to prevent sleep, adding further stress to the animal. Deep brain electrical stimulation (DBES) of the brainstem reticular formation is a less common technique used to prevent sleep, and while this methodology may also carry unwanted effects, it avoids stressful conditions. In the present study, we examined the relationship between sleep and nursing, and how different sleep deprivation methodologies impact nursing and lactation. For this purpose, we carried out two sets of experiments. First, we correlated sleep and waking states with different nursing parameters of lactating rats under undisturbed conditions. Second, we slept deprived another group of mother rats using two different techniques: GH and DBES. Our main findings show that sleeping time was positively correlated with the time devote to nurse the pups, but not either with milk ejection or pup weight gain. When mother rats were sleep deprived, maternal behavior was fragmented using both methods, but was substantially more disrupted when using GH. Additionally, lactating dams were capable of ejecting milk and their pups gained weight despite of being sleep deprived using both techniques, but these parameters were significantly reduced using GH compared to control values, while DBES did not differ from control group. Overall, these results suggest that sleep and nursing are behaviorally compatible, but in disagreement with previous findings, we concluded that sleep is not necessary for milk ejection. These observations have critical implications for using the rat as a model to explore sleep loss during the postpartum period.


Subject(s)
Lactation , Sleep Deprivation , Female , Humans , Rats , Animals , Swine , Rabbits , Lactation/physiology , Milk Ejection , Sleep/physiology , Weight Gain , Mammals
17.
J Dairy Sci ; 106(1): 294-301, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36333147

ABSTRACT

This study documents the effect of mechanical prestimulation on the milking duration of pasture-based cows in late lactation to better harness increased capacity of automation in the milk harvesting process. Premilking stimulation, provided via manual or mechanical means, has been shown to promote the milk letdown reflex and assist in achieving quick, comfortable, and complete milk removal from the udder. The literature is lacking knowledge on the effect of mechanical premilking stimulation on milking duration, especially in late lactation and in pasture-based systems, and many pasture-based farms do not practice a full premilking routine because of a lack of labor availability. The current study addresses this gap in knowledge. In this study, we tested 2 treatments: (1) the No Stim treatment used normal farm milking settings with no premilking preparation and (2) the Stim treatment used 60 s of mechanical premilking stimulation, with a rate of 120 cycles per minute and a pulsator ratio of 30:70 on cluster attachment. Once the 60 s of stimulation had elapsed, normal milking settings resumed for the remainder of the milking. Sixty cows were enrolled in the study, which ran for 20 d. The effect of treatment on a.m. milking duration was significant, a.m. milking duration for Stim was 12 s shorter than that of No Stim. The effect of treatment on p.m. milk duration was not significant. Treatment had no effect on a.m./p.m. milk yields, average milk flowrates or peak milk flowrates. Significant differences emerged between treatments on a.m. and p.m. dead time (time from cluster attachment to reach a milk flowrate of 0.2 kg/min). The a.m. and p.m. dead times were 6 s shorter for Stim compared with No Stim. The time taken to achieve peak milk flowrate (time to peak) at morning milking was 7 s shorter for Stim compared with No Stim, and treatment yielded no significant effects on time to peak at p.m. milkings. Treatment also had no significant effect on log10 somatic cell count. Although the percentage of congested teat-ends and teat-barrels was numerically lower for Stim versus No Stim, no statistical differences were detected across these measures. Based on the results of the study, we found merit in applying 60 s of mechanical pre-stimulation at a.m. milking from a milking duration perspective. However, the strategy was not as successful for the p.m. milking. Analysis of the milk flowrate profiles recorded during the study suggest potential utility in employing different machine settings for various milkings based on anticipated yield and level of udder fill.


Subject(s)
Dairying , Milk , Female , Cattle , Animals , Dairying/methods , Lactation/physiology , Mammary Glands, Animal/physiology , Milk Ejection
18.
J Dairy Sci ; 105(8): 6936-6946, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35773032

ABSTRACT

Delayed milk ejection, manifested most often as bimodal milk flow, occurs when the cisternal milk fraction is removed before the alveolar milk reaches the gland cistern. It is thought to be a consequence of not meeting cows' physiological needs, due to insufficient premilking teat stimulation, inadequate timing of milking unit attachment, or both. It has been associated with decreased milking efficiency, reduced milk yield, and impaired teat and udder health. Traditionally, portable electronic milk meters have been used to assess the presence of delayed milk ejection in dairy cows. By contrast, incremental milk flow rates from on-farm milk meters and their suitability as a measure to assess delayed milk ejection have not been studied by rigorous methods. The objectives were (1) to describe a protocol for identification of cows with chronically delayed milk ejection (CDME) and (2) to investigate risk factors for CDME using incremental milk flow rates obtained from automated on-farm milk meters. In a retrospective case control study, milk flow data from a 4,300-cow dairy with a thrice-daily milking schedule were obtained over a 1-wk period. Incremental milk flow rates (0-15 s, 15-30 s, 30-60 s, and 60-120 s) were used to identify cows with delayed milk ejection. Cases of CDME were defined as presence of delayed milk ejection at all 21 milking observations. Cows that had no delayed milk ejection at any of the same 21 milking observations were included as controls. A total of 171 cases and 393 controls were included in the study based on these criteria. A logistic regression model was used to evaluate associations of the following risk factors with CDME: parity (1, 2, ≥3), stage of lactation (<100, 101-200, >200 DIM), presence of a nonlactating quarter, milk somatic cell count, average daily milk production, and health and management events. Parity and CDME were associated such that compared with cows in their third or greater lactation, the odds (95% confidence intervals, 95% CI) of CDME were 1.27 (0.71-2.25) for cows in their first and 4.77 (2.47-9.22) for animals in their second lactation. The odds of CDME increased with increasing stage of lactation, with an odds ratio of 0.20 (0.11-0.36) for early and 0.28 (0.15-0.52) for mid-lactation animals, respectively, compared with late lactation cows. A 1-kg increase in average daily milk production was associated with decreased odds of CDME [odds ratio (95% CI): 0.89 (0.87-0.92)]. A lameness event during the study period increased the odds of CDME [odds ratio (95% CI): 8.04 (1.20-53.83)], as did a vaccination event 1 wk before the study period [odds ratio (95% CI): 4.07 (0.99-16.71)]. This study confirmed associations between CDME and previously reported risk factors and identified several previously less rigorously investigated health and management events that could be associated with CDME. Incremental milk flow rates from individual cows serve as an automated tool to evaluate milk flow dynamics. This information could be used to improve individual premilking udder preparation to meet the animal's physiological requirements, improve teat and udder health, and enhance parlor efficiency.


Subject(s)
Cattle/physiology , Dairying/methods , Milk Ejection/physiology , Animals , Case-Control Studies , Female , Lactation/physiology , Mammary Glands, Animal/physiology , Milk/physiology , Pregnancy , Retrospective Studies , Risk Factors , Time Factors
19.
J Dairy Sci ; 105(2): 1533-1541, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34955277

ABSTRACT

Adequate prestimulation is considered a requirement for a fast, gentle, and complete udder emptying at machine milking. Reduced vacuum or reduced liner-open phase of pulsation (or both) may replace prestimulation and consequently reduce work load of the milker and increase parlor efficiency. In the present study we compared 2 milking routines (MR) with manual prestimulation (LPrep = long preparation: 15 s of forestripping, teat cleaning, and stimulation; SPrep = short preparation: 5 s of teat cleaning) followed by 1-min latency period and milking at standard vacuum and pulsation settings (claw vacuum 44 kPa, pulsation rate 60 cycles/min, pulsation ratio 65/35) with 2 MR consisting of 5 s of teat cleaning, immediate cluster attachment and milking at reduced vacuum with or without shortened liner-open phase of pulsation until milk flow exceeded 400 g/min (RP = reduced pulsation: pulsation ratio 30/70, pulsation rate 50 cycles/min, claw vacuum 44 kPa; RPV = reduced pulsation and vacuum: pulsation ratio 30/70, pulsation rate 50 cycles/min, claw vacuum 34 kPa). Cluster detachment was performed at 400 g/min in all MR. Ten Holstein dairy cows were milked twice daily at 14-h and 10-h milking intervals. Milk flow and electrical conductivity (EC) were recorded throughout milking. During the first 2 min of each milking ultrasound cross-section images of the gland cistern of one front quarter were recorded, and 5 min after the end of milking teat tissue thickness of both front teats was measured by using a cutimeter. Most milking characteristics such as total milk yield, average milk flow, and machine-on time reached higher values at 14-h than 10-h milking intervals, but did not differ among MR. However, the occupancy time (time from the first touch of the udder until cluster detachment) was considerably shorter in RP and RPV compared with LPrep and SPrep. Ultrasound cross section areas of the gland cistern were larger in LPrep than in RP and RPV indicating that milk ejection already occurred at cluster attachment in LPrep. This assumption is also supported by the lower EC at cluster attachment in LPrep than in RP and RPV, which was caused by the presence of alveolar milk in the gland cistern after milk ejection. The MR RP and RPV increase parlor efficiency and are work-saving alternatives to MR, which include an adequate prestimulation (LPrep). However, shortening prestimulation to a 5-s teat cleaning followed by a latency period and milking at regular vacuum and pulsation is not adequate to save occupancy time. Because milking was performed at a relatively low vacuum (44 kPa) and at a detachment level of 400 g/min, teat tissue thickness did not differ among MR, and the vacuum reduction in RPV did not cause an additional advantage for teat condition compared with RP.


Subject(s)
Dairying , Lactation , Animals , Cattle , Female , Mammary Glands, Animal , Milk , Milk Ejection , Vacuum
20.
Anim Sci J ; 92(1): e13646, 2021.
Article in English | MEDLINE | ID: mdl-34655139

ABSTRACT

The present experiments on goats were conducted with the aim of verifying (a) whether the identity of the goat kids can affect the characteristics of milk let-down during suckling (Study 1) and (b) whether the presence of the goat kids may improve the milk let-down during hand milking (Study 2). In Study 1, 16 lactating goats with twins and 12 with single kids were used. Dams with single goat kids ejected more milk when suckling their kids at Days 5 and 20 of lactation, than when suckling aliens. Dams with twins ejected more milk when suckling their own kids than aliens only at Day 5 of lactation. Taking into account all the dams, they ejected more milk with more fat, protein, and lactose during suckling their own litter than when suckling aliens. In Study 2, when dams (n = 13) were hand milked in the presence of their own litter or in its absence, they ejected more milk with more fat, protein, and lactose than when milked in the presence of alien kids. We conclude that milk let-down in goats can be influenced by the type of stimuli applied or to which they are exposed to during suckling and milking.


Subject(s)
Goats , Lactation , Milk Ejection , Animals , Female , Lactose , Milk
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