55 Milk Expression Habits in Maternal Milk Donors: Should We Favor Hindmilk Banking for Extremely Preterm Infants?
Notice bibliographique
Résumé
Abstract Background A maternal milk bank was established in 2014 in Québec. The caloric contents of pooled milk lots ranges from 58-73 calories/100 ml, whereas most babies need ≥82 calories/100 ml. Hindmilk is 2-3 times fatter than foremilk, contains more protein and would be ideal for the most fragile extremely preterm infants. This would avoid adding cow-milk protein fortifier in the first weeks of life. Hindmilk is only released 2-3 minutes post-letdown, so that the milk expression habits of donating mothers may influence caloric content. These habits are ill-documented, and precise recommendations on milk expression habits are needed. Objectives The objective of this study was to examine the feasibility of hindmilk expression by breastmilk donors so as to provide it for the most fragile preterm infants. Design/Methods In 2021, an electronic questionnaire was emailed to all active milk donors in Québec to collect data on their milk expression habits and their willingness to change them. The questionnaire contained both closed and open-ended questions. Response were analyzed using mixed methods. Results In total, 126 out of 181 donors (70%) completed the questionnaire. Most participants (78%) had a university degree, and 65.0% had >1 pregnancy. Overall, 98% were comfortable or very comfortable with current recommendations on milk expression, and 91% were aware or well aware of the benefits of maternal milk for preterm babies. Concerning breastfeeding habits, 68% reported expressing milk for banking between breastfeedings; 18% reported expressing milk for banking from one breast while keeping the milk from their other breast for their baby; and 14% reported breastfeeding their baby on each breast and keeping hindmilk for banking. Overall, 66% of participants said they would be willing to change their habits most or all the time to provide hindmilk for the most fragile babies. The main theme invoked in open-ended answers was altruism, and gratitude for being able to help others. On the other hand, few participants commented on the complexity of milk expression or reported that additional restrictions might discourage them from donating. Conclusion Most participating mothers were already giving foremilk and hindmilk. A significant proportion of respondents said they would agree to change their expression habits in favour of giving hindmilk to be used for only the most fragile infants. More information is needed on how changing recommendations for milk expression might impact the supply and caloric content of mothers’ milk.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».