Testing Relationships of Breastmilk Intake Indicators with Actual Breastmilk Intake
The objective of study was to determine relationships between breastfeeding indicator scores using commonly recognized breastfeeding biobehaviors with actual neonatal breastmilk intake in order to develop a valid assessment tool to identify breastfeeding infants at-risk.
Design: A descriptive prospective design was used.
Population, Sample Setting, Years: The study sample was 41 healthy term breastfeeding infants and their mothers at two midwestern hospitals who delivered during the summer of 2000. Mother/baby pairs who qualified for the study were selected from the total population on an as-they-come basis.
Outcome Variable: Amount of infant breastmilk intake during one feeding as measured by an electronic scale.
Methods: Using a valid infant scale, the Smart Model 20 Olympic Medical, Seattle Washington (Meier, 1994), infants were weighed prior to a breastfeeding, assessed for breastfeeding using common breastfeeding biobehaviors, (latch-on, suckle, audible swallowing, mother’s evaluation, rooting, and length of time before the infant latched on the breast) and then weighed again after breastfeeding to determine the amount of mother’s milk in milliliters (ml) ingested by the baby. This one-time assessment was performed on the second or third day postpartum.
Findings: The amount of mother’s milk ingested by the neonates, as indicated by weight change, varied widely and ranged from 0 to 103 ml. The average intake was 29 ± 30.6 ml. Milk intake was positively related with the feeding indicators. A step-wise multiple regression analysis indicated that the best single indicator that predicted the amount of mother’s milk ingested by the infant was swallowing. Overall swallowing explained 18% of the variance (multiple r=0.427, p<0.01). Three combined indicators (mother’s score, rooting and swallowing explained 49% of the variance (multiple r=0.701, p<0.10).
Conclusions Certain breastfeeding indicators predict the actual amount of infant breastmilk intake. This study provides promising data that strongly suggests further investigation of breastfeeding biobehavioral indicators using a larger, more diverse sample of mothers and infants.
Implications: A larger sample would confirm which indicators to combine into an assessment tool that would provide the best estimate of mother’s milk intake by healthy term neonates. Such a tool would identify breastfeeding neonates at-risk.
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