Comparative Assessment of Excretion of Milk from Two Breast Pumps with Different Vacuum Strength and Duration.

BACKGROUND: Breastfeeding is the best source of food for the newborn. In a situation wherein it is not possible to breastfeed a baby, it may be necessary to express milk from the mother's breast using a breast pump. To achieve lactation success before a baby's suckling can ensure the effective extraction of milk, breast pumps must meet specific biomechanical requirements. However, the parameters of the vacuum stimuli by which milk is expressed remain nonoptimized. SUBJECTS AND METHODS: Forty-nine lactating women of 21-30 years of age who volunteered to be included in this study were examined. Women had been lactating and breastfeeding normally for 6-7 days. A new method was developed to compare the amount of milk ejected by vacuum pulses of different amplitudes or duration. RESULTS: It was found that for most nursing women, the vacuum stimuli with amplitude of about 190 mm Hg, duration of 0.7 second, and frequency of 1 impulse/s are optimal for removing milk from the breast of a woman. CONCLUSIONS: Optimization of the amplitude and duration of the vacuum stimuli increased the efficacy of the breast pump.

Progesterone-Containing Gel Does Not Eliminate Postpartum Breast Engorgement?

BACKGROUND: Severe breast engorgement can cause substantial discomfort for mothers and interfere with an infant's ability to feed at the breast. The aim of the study was to clarify the possibility that the percutaneous progesterone-containing gel (Progestogel) can eliminate severe postpartum breast engorgement in lactating women. SUBJECTS AND METHODS: Twenty three patients were examined. The Progestogel for transdermal therapy in an amount of 2.5-3 g was applied to the breast. Before application and 20 min after application the density of the mammary glands was measured by a tonometer. RESULTS: According to our observations, within 20 min application of 2.5-3 g of the Progestogel on the breast skin does not result in reducing breast swelling, engorgement and tenderness. CONCLUSIONS: After 20 minutes, transdermal application of Progestogel does not reduce the degree of engorgement of the mammary glands in the postpartum period.

The Mechanics of Breast Pumping: Compression Stimuli Increased Milk Ejection.

BACKGROUND: The use of breast pumps with a compression component has shown their higher efficacy compared with vacuum pumps. However, the direct role of the compression stimulus is not sufficiently proven in the removal of milk from the main milk ducts of the breast. The aim of this study was to determine the contribution pulsating compression component of the breast pump has on total volume milk ejection by vacuum and compression stimuli. SUBJECTS AND METHODS: Twenty-four lactating women of 21-30 years of age, who volunteered to be included in this study, were examined. Experimental breast pump with vacuum and compressive components were used to express breast milk. RESULTS: It was found that volume milk ejection together with vacuum and compression stimuli was 10-46% more than expressing only with vacuum stimuli. Average values were 40.5% ± 5% for expression only with vacuum stimuli and 59.5% ± 5% for expression with vacuum and compression stimuli. CONCLUSIONS: Compression stimuli increased the efficacy of the breast pump, which is not only due to the effective formation milk ejection reflex but also directly to an additional squeezing of milk from the breast.

Pathological postpartum breast engorgement: prediction, prevention, and resolution.

BACKGROUND: Severe breast engorgement can cause substantial discomfort for mothers and interfere with an infant's ability to feed at the breast. This study explored the possibility of prediction of pathological postpartum breast engorgement in lactating women in relation to intense breast engorgement at the end of the luteal phase of the menstrual cycle and the possibility of prevention and resolution of postpartum breast engorgement with expression with a breast pump of colostrum before the appearance of transitional milk. SUBJECTS AND METHODS: The first group included 70 women with pathological postpartum breast engorgement. The second group included 52 postpartum women, with 24 women having colostrum extracted by the breast pump from each breast once or twice for a duration of 20-25 minutes sequentially in the first 2-3 days after delivery in addition to the removal of colostrum by the baby, before engorgement developed. Twenty-eight women had colostrum removed only by the baby. The degree of breast engorgement was assessed using the previously published Robson four-level scale. RESULTS: Of the 70 patients with severe postpartum engorgement studied in the first group, 90% showed intense breast engorgement in the late luteal phase of the menstrual cycle. Expression of colostrum milk in the first experimental group from each breast eliminated excessive breast engorgement in breastfeeding mothers. CONCLUSIONS: Presence of intense breast engorgement at the end of the luteal phase of the menstrual cycle may be one of the most important indicators useful for predicting severe postpartum breast engorgement. Extraction of colostrum before the appearance of transitional milk lowers the risk of excessive engorgement in breastfeeding women.