This is a study of the early management of breastfeeding. The long-term objective is to validate direct interventions which can be used by nurses to promote successful breastfeeding experiences for mothers and their infants, since breastfeeding for at least six months has been found to be advantageous to the health of infants. The first specific aim is to develop a simple, inexpensive, non-invasive tool which nurses can readily use to monitor the early lactation process. A filter paper-based measure of milk maturation called the Combined Emulsion Color Scale (CECS) will be further validated by testing the following hypotheses: 1) using the CECS to distinguish milk patterns one, two, and three, inter-rater reliability will be above 0.90; 2) using the CECS to compare foremilk, midmilk, and hindmilk from the same feed, test-retest reliability will be above 0.90; 3) using biochemical analysis for percent fat, carotenoids, and ratio of fat to phosphorus and cholesterol, concurrent validity with the CECS will be above 0.90. The second specific aim will be to document the effect of nursing management routines on the rate at which the mature milk is established in new mothers. Management routines will include timing of the first feeding and number of feedings in the first three days. The relationship of these management variables will be compared in the short term to milk maturation rate as measured by the CECS. In a longer term, the early management variables and the late CECS pattern change will be compared with weight gain, infant hydration, bilirubin levels, mother's satisfaction with breastfeeding and mother's perception of problems, and number of weeks the infant is breastfed. The study is observational in nature. Procedures include collecting samples of breast milk and observational data from hospitalized mothers and infants. Additional information will be collected at 14 and 28 days in home visits. The study results will provide a research basis for establishing management routines for breastfeeding mothers and early identification of mothers anad infants in need of extra support.
| Humenick, S S; Mederios, D; Wreschner, T B et al. (1994) The Maturation Index of Colostrum and Milk (MICAM): a measurement of breast milk maturation. J Nurs Meas 2:169-86 |
