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More-nutritious breast milk for preemies

Feeding a tiny preterm baby is a serious challenge, but new findings from Stanford may help.

Many babies born three or more weeks early can't breastfeed. The youngest preemies' digestive systems are too immature to handle milk, and those born further along in pregnancy don't suckle aggressively enough to get the nourishment they need. Doctors also debate whether human milk is rich enough for preemies, and many of these babies are fed human milk supplemented with powdered cow's milk protein to give more calories per gulp.

All of this creates a dilemma for preemies' moms, who often want to provide breast milk but don't have a baby at the breast. A Stanford team led by neonatologist William Rhine, MD, recently published the second of two papers showing that a combination of electric pumping and hand expression can get mom's milk production up to speed. Electric pumps aren't as good as a baby at getting milk out of the breast; the first paper demonstrated that mothers who followed each electric pumping session with hands-on compressions of the breast extracted more milk and boosted their long-term milk production.

The new paper, which appeared Jan. 5 in the Journal of Perinatology, evaluated the nutrient composition of milk from mothers who combined electric and hands-on pumping methods.

"People have suspected that mothers would be able to get more fat-rich milk with hands-on pumping but it's never been demonstrated before," said Jane Morton, MD, a community pediatrician who was the new paper's first author. The suspicion arose because milk composition changes during a feeding, shifting from more-dilute milk at first to richer, higher-fat "hindmilk" at the end. Extracting more high-fat hindmilk could give preemies an important calorie boost.

The researchers' findings confirmed that moms who used hands-on pumping had higher fat content in their milk than women relying on electric pumps alone.

"There seems to be real value added" by the hands-on pumping, Morton said.

Image by Bush Library

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