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Dynamics of milk flow and milk ejection Dynamics of milk flow and milk ejection... - Complex Object ()
Dynamics of milk flow and milk ejection during breast expression in women / Danielle Kaye Prime
[Truncated abstract] The milk ejection reflex is crucial for successful lactation but has been difficult to characterize in women due to the invasiveness and technical demand of previous methodologies. Women are increasingly using breast pumps to express their milk in Western societies in order to meet the WHO exclusive breastmilk feeding recommendations, as well as to provide milk to premature and sick infants. Indeed, premature infants now make up approximately 13% of births in the United States (CDC 2009), and with improving medical technology it is very likely that this proportion will continue to increase, further increasing the need for alternate methods of milk removal. I aimed to validate a non-invasive device (the Showmilk) for its ability to measure the dynamics of milk flow and milk ejection during breast expression to advance understanding of the physiology of milk removal, and improve clinical guidelines. Experiments were performed in healthy breastfeeding women. Milk was expressed using an electric breast pump on either both breasts (simultaneous, n=34) or a single breast (n=20). Milk was collected onto the Showmilk device which recorded the cumulative milk volume from which the milk flow rate (g/s) was obtained. All mothers were asked to measure their 24h milk productions and simultaneous expression was repeated three times in three weeks in 25 women, as well as at 6 (n=8), 9 (n=7) and 12 (n=5) months of lactation. Ultrasound was used on 14 mothers to identify milk ejection as an increase in milk duct diameter, and ultrasound measurements of breast anatomy were performed on a further 17 mothers. Single breast expression was used to determine the effect of three breastshield sizes (24mm, 27mm and 30mm) on expression efficacy, efficiency and milk ejection. Increases in milk duct diameter correlated with transient increases in milk flow rate 72% of the
time. Left and right breasts had similar dynamics of milk removal during simultaneous breast expression, with 95.5% of milk ejections occurring simultaneously in both breasts. Milk emptied followed a typical decay curve, with the first seven minutes more active for milk removal than the last seven minutes. Milk flow slowed at the 8th minutes where 54±25% of the available milk and 86±9% of the expression volume had been removed. The maximum milk flow rate was predictive of the total expression volume, and a higher amount of available milk in the breast resulted in less of the available milk being removed...
Thesis (Ph.D.)--University of Western Australia, 2010
Release Date
2011- 05
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