Journal
BREASTFEEDING MEDICINE
Volume 17, Issue 2, Pages 173-181Publisher
MARY ANN LIEBERT, INC
DOI: 10.1089/bfm.2021.0167
Keywords
maternal obesity; prepregnancy BMI; human milk biomarker; secretory activation
Categories
Funding
- Department of Pediatrics
- Medela LLC
- Rush University College of Nursing, International Society for Research in Human Milkand Lactation, and the Family Larsson-Rosenquist Founda-tion Trainee Travel Fund
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There is limited knowledge about secretory activation in overweight and obese mothers who are breast pump dependent with a premature infant in the neonatal intensive care unit. Research suggests that there is delayed or impaired SA in this population, with the window of opportunity for research and clinical interventions being the first 1-7 days postpartum.
Background: Little is known about the biology of secretory activation (SA) in overweight and obese (OW/OB) mothers who are breast pump dependent with a premature infant in the neonatal intensive care unit.Objective: To compare time-dependent changes in daily pumped milk volume, maternal milk sodium (Na) concentration, and Na-to-potassium (K) ratios (Na:K) in the first 14 days postpartum in breast pump-dependent mothers with prepregnancy body mass index (BMI) Design/Methods: This secondary analysis for 39 subjects, 44% (n = 17) with prepregnancy BMI <27 and 56% (n = 22) with BMI >= 27, included transformed data of outcome measures, chi-square, t-tests, and growth curve models.Results: For days 1-7, daily pumped milk volume increased significantly more rapidly for mothers with BMI <27 (65.82 mL/d) versus BMI >= 27 (33.08 mL/d), but the daily rate of change in pumped milk volume during days 8-14 was not statistically different. Daily milk Na concentration decreased significantly faster in BMI <27 (-3.93 mM/d) versus BMI >= 27 (-2.00 mM/day) during days 1-7, but was not significantly different for days 8-14. No statistical differences were noted for Na:K ratio for either time period.Conclusion: These data add biologic evidence to previous research, suggesting delayed or impaired SA in OW/OB mothers, and suggest that the window of opportunity for research and clinical interventions is days 1-7 postpartum in this population.
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