The Research On Milk Volume And Influencing Factors In Mothers With Preterm Infants Hospitalized In NICU

Objective:Continuous assessment of milk production in mothers with preterm infants hospitalized in NICU,investigate its milk secretion regularity and analyze the factors associating with the milk production.Methods:Continuous measurements of daily breastmilk production were preformed to mothers with preterm infants hospitalized in NICU.The maternal lactation related comprehensive questionnaire and Edinburgh Postnatal Depression Scale(EPDS)were used to investigated the influencing factors for milk production.Results:1.The mean milk volume from day 1 to day 14 postpartum was(0.85± 1.92)ml-(535.43±265.97)ml,53%of the premature mothers had insufficient milk production,the mean milk volume for these mothers was(341.08±89.70)ml.There was a significant positive correlation between the daily milk volume of the first 14 days postpartum.The correlation coefficient of lactation between day 4 and day 14 was 0.7070(P<0.01).2.Logistic regression analysis showed that the influencing factors of the insufficient milk volume were maternal age,pregnancy induced hypertension syndrome,initiation of lactogenesis II,EPDS score.3.The incidence rate of delayed onset of lactogenesis II was 36%.There is a negative correlation between the timing of lactogenesis II and the milk production of 14 days postpartum(r=-0.525～-0.354,P<0.05/14).The milk production during 14 days postpartum for the delayed onset of lactogenesis II group were lower than those of the non-delayed onset of lactogenesis group(z=-4.89～-3.10,P<0.05/14).The influencing factors of the delayed onset of lactogenesis II were pregnancy induced hypertension syndrome,initiation time of milk expression,sleep time.4.The positive rate of postpartum depression among preterm mothers was 58%(58/100).The Spearman rank correlation analysis shows that the EPDS score had a negative effect on milk volume at day 2 and day 11 to day 14 postpartum(r=-0.35～-0.38,P<0.05/14).Positive group reported lower milk volume than normal group during day 11 to day 14 postpartum(z=-3.87～-3.58,P<0.05/14).Conclusions:1.The milk volume of mothers with preterm infants was relatively lower compared with mothers with full-term infants during the early stage postpartum,and the incidence of insufficient milk volume for the mothers was higher.2.Day 4 postpartum is a critical time point for lactation evaluation.Mothers with low milk production on day 4 postpartum should be pay high attention and take effective measures to improve its lactation timely.3.The influencing factors of the insufficient milk volume were maternal age,pregnancy induced hypertension syndrome,initiation of lactogenesis Ⅱ,EPDS score.