The Experts below are selected from a list of 3702 Experts worldwide ranked by ideXlab platform

Andrei V Krassioukov - One of the best experts on this subject based on the ideXlab platform.

Viviane Silva Coentro - One of the best experts on this subject based on the ideXlab platform.

  • Nipple shield use does not impact sucking dynamics in Breastfeeding infants of mothers with nipple pain
    European Journal of Pediatrics, 2021
    Co-Authors: Viviane Silva Coentro, Ching Tat Lai, Alethea Rea, Sharon Lisa Perrella, Michael Dymock, Donna Tracy Geddes
    Abstract:

    Nipple shields (shield) may reduce pain during Breastfeeding, but the impact on infant sucking dynamics is not known. We examined the effects of shield use on sucking dynamics, milk removal and nipple pain in two groups of Breastfeeding dyads: pain group (PG): shield used for nipple pain; comparison group (CG): no Breastfeeding Difficulties. Twenty PG (6 ± 4 weeks postnatal) and 28 CG dyads (8 ± 6 weeks postnatal) attended 2 monitored Breastfeeding sessions with shield use randomised. Within-subject outcomes were compared. PG: shield use did not affect intra-oral vacuum (peak p = 0.17, baseline p = 0.59), sucking frequency ( p = 0.20) or milk transfer (40 mL vs 48 mL, p = 0.80; percentage of available milk removed (PAMR) 55% vs 57%, p = 0.88), and reduced McGill pain scores ( p = 0.012). CG: shield use increased non-nutritive sucking (10% more, p = 0.049), and reduced nutritive sucking (18% less, p = 0.017) and milk transfer (63 mL vs 31 mL p < 0.001, PAMR 65% vs 36% p < 0.001). For both groups, feeding duration increased by 2 min ( p < 0.0001) and non-nutritive portions of the feed increased with shield use. Conclusion : Nipple shield use improved maternal comfort and did not impact milk removal or sucking strength in PG, but significantly reduced milk transfer and nutritive sucking in CG. What is Known: • Mothers report that nipple shields reduce nipple pain and enable continued Breastfeeding. • Concerns that nipple shield use may reduce milk transfer and alter infant sucking patterns are based on limited published evidence. What is New: • Nipple shield use is associated with a 25% reduction in pain scores in Breastfeeding mothers with chronic nipple pain. • Milk transfer is not reduced in dyads that regularly use a shield for chronic nipple pain. • Intra-oral vacuums are not impacted by nipple shield use in mothers experiencing pain.

  • effect of nipple shield use on milk removal a mechanistic study
    BMC Pregnancy and Childbirth, 2020
    Co-Authors: Viviane Silva Coentro, Sharon L Perrella, Ching Tat Lai, Alethea Rea, Kevin Murray, Donna T. Geddes
    Abstract:

    Concerns about reduced milk transfer with nipple shield (NS) use are based on evidence from studies with methodological flaws. Milk removal during Breastfeeding can be impacted by infant and maternal factors other than NS use. The aim of this study was to control electric breast pump vacuum strength, pattern and duration across multiple study sessions to determine if NS use reduces milk removal from the breast. A within-subject study with two groups of Breastfeeding mothers (infants < 6 months) were recruited; Control Group (CG): no Breastfeeding Difficulties; Pain Group (PG) used NS for persistent nipple pain. Mothers completed three randomised 15 min pumping sessions using the Symphony vacuum curve (Medela AG); no NS, fitted NS, and a small NS. Sessions were considered valid where the applied vacuum was within 20 mmHg of the set vacuum. Milk removal was considered as pumped milk volume, and also percentage of available milk removed (PAMR), which is calculated as the pumped volume divided by the estimated milk volume stored in the breast immediately prior to pumping. Of 62 sessions (all: n = 31 paired sessions) a total of 11 paired sessions from both PG (n = 03) and CG (n = 08) were valid (subset) with and without a fitted NS. Only 2 small shield sessions were valid and so all small shield measurements were excluded. Both pumped volumes and PAMR were significantly lower with NS use for all data but not for subset data. (All: Volume and PAMR median: no NS: 76.5 mL, 69%, Fitted NS: 32.1 mL, 41% respectively (volume p = 0.002, PAMR p = 0.002); Subset: Volume and PAMR median: no NS: 83.8 mL, 72%; Fitted NS: 35.2 mL, 40% (volume p = 0.111 and PAMR p = 0.045). The difference in PAMR, but not volume, was statistically significant when analysed by linear mixed modelling. A decrease of 10 mmHg was associated with a 4.4% increase in PAMR (p = 0.017). This experimental data suggests that nipple shield use may reduce milk removal. Close clinical monitoring of Breastfeeding mothers using nipple shields is warranted.

Donna T. Geddes - One of the best experts on this subject based on the ideXlab platform.

  • effect of nipple shield use on milk removal a mechanistic study
    BMC Pregnancy and Childbirth, 2020
    Co-Authors: Viviane Silva Coentro, Sharon L Perrella, Ching Tat Lai, Alethea Rea, Kevin Murray, Donna T. Geddes
    Abstract:

    Concerns about reduced milk transfer with nipple shield (NS) use are based on evidence from studies with methodological flaws. Milk removal during Breastfeeding can be impacted by infant and maternal factors other than NS use. The aim of this study was to control electric breast pump vacuum strength, pattern and duration across multiple study sessions to determine if NS use reduces milk removal from the breast. A within-subject study with two groups of Breastfeeding mothers (infants < 6 months) were recruited; Control Group (CG): no Breastfeeding Difficulties; Pain Group (PG) used NS for persistent nipple pain. Mothers completed three randomised 15 min pumping sessions using the Symphony vacuum curve (Medela AG); no NS, fitted NS, and a small NS. Sessions were considered valid where the applied vacuum was within 20 mmHg of the set vacuum. Milk removal was considered as pumped milk volume, and also percentage of available milk removed (PAMR), which is calculated as the pumped volume divided by the estimated milk volume stored in the breast immediately prior to pumping. Of 62 sessions (all: n = 31 paired sessions) a total of 11 paired sessions from both PG (n = 03) and CG (n = 08) were valid (subset) with and without a fitted NS. Only 2 small shield sessions were valid and so all small shield measurements were excluded. Both pumped volumes and PAMR were significantly lower with NS use for all data but not for subset data. (All: Volume and PAMR median: no NS: 76.5 mL, 69%, Fitted NS: 32.1 mL, 41% respectively (volume p = 0.002, PAMR p = 0.002); Subset: Volume and PAMR median: no NS: 83.8 mL, 72%; Fitted NS: 35.2 mL, 40% (volume p = 0.111 and PAMR p = 0.045). The difference in PAMR, but not volume, was statistically significant when analysed by linear mixed modelling. A decrease of 10 mmHg was associated with a 4.4% increase in PAMR (p = 0.017). This experimental data suggests that nipple shield use may reduce milk removal. Close clinical monitoring of Breastfeeding mothers using nipple shields is warranted.

  • frenulotomy for Breastfeeding infants with ankyloglossia effect on milk removal and sucking mechanism as imaged by ultrasound
    Pediatrics, 2008
    Co-Authors: Donna T. Geddes, Diana B Langton, Ian Gollow, Lorili A Jacobs, Peter E Hartmann, Karen Simmer
    Abstract:

    OBJECTIVE. There is evidence that infants with ankyloglossia can experience Breastfeeding Difficulties including poor attachment to the breast, suboptimal weight gain, and maternal nipple pain, which may lead to early weaning of the infant. No studies have investigated the cause of these Breastfeeding Difficulties. The objective of this study was to determine the effectiveness of frenulotomy in infants experiencing persistent Breastfeeding Difficulties despite professional assistance by measuring changes in milk transfer and tongue movement during Breastfeeding before and after frenulotomy. PATIENTS AND METHODS. Twenty-four mother-infant dyads (infant age: 33 ± 28 days) that were experiencing persistent Breastfeeding Difficulties despite receiving professional advice were recruited. Submental ultrasound scans (Acuson XP10) of the oral cavity were performed both before and ≥7 days after frenulotomy. Milk transfer, pain, and LATCH (latch, audible swallowing, type of nipple, comfort, and hold) scores were recorded before and after frenulotomy. Infant milk intake was measured by using the test-weigh method. RESULTS. For all of the infants, milk intake, milk-transfer rate, LATCH score, and maternal pain scores improved significantly postfrenulotomy. Two groups of infants were identified on ultrasound. One group compressed the tip of the nipple, and the other compressed the base of the nipple with the tongue. These features either resolved or lessened in all except 1 infant after frenulotomy. CONCLUSIONS. Infants with ankyloglossia experiencing persistent Breastfeeding Difficulties showed less compression of the nipple by the tongue postfrenulotomy, which was associated with improved Breastfeeding defined as better attachment, increased milk transfer, and less maternal pain. In the assessment of Breastfeeding Difficulties, ankyloglossia should be considered as a potential cause.

Stacy Elliott - One of the best experts on this subject based on the ideXlab platform.

Ching Tat Lai - One of the best experts on this subject based on the ideXlab platform.

  • Nipple shield use does not impact sucking dynamics in Breastfeeding infants of mothers with nipple pain
    European Journal of Pediatrics, 2021
    Co-Authors: Viviane Silva Coentro, Ching Tat Lai, Alethea Rea, Sharon Lisa Perrella, Michael Dymock, Donna Tracy Geddes
    Abstract:

    Nipple shields (shield) may reduce pain during Breastfeeding, but the impact on infant sucking dynamics is not known. We examined the effects of shield use on sucking dynamics, milk removal and nipple pain in two groups of Breastfeeding dyads: pain group (PG): shield used for nipple pain; comparison group (CG): no Breastfeeding Difficulties. Twenty PG (6 ± 4 weeks postnatal) and 28 CG dyads (8 ± 6 weeks postnatal) attended 2 monitored Breastfeeding sessions with shield use randomised. Within-subject outcomes were compared. PG: shield use did not affect intra-oral vacuum (peak p = 0.17, baseline p = 0.59), sucking frequency ( p = 0.20) or milk transfer (40 mL vs 48 mL, p = 0.80; percentage of available milk removed (PAMR) 55% vs 57%, p = 0.88), and reduced McGill pain scores ( p = 0.012). CG: shield use increased non-nutritive sucking (10% more, p = 0.049), and reduced nutritive sucking (18% less, p = 0.017) and milk transfer (63 mL vs 31 mL p < 0.001, PAMR 65% vs 36% p < 0.001). For both groups, feeding duration increased by 2 min ( p < 0.0001) and non-nutritive portions of the feed increased with shield use. Conclusion : Nipple shield use improved maternal comfort and did not impact milk removal or sucking strength in PG, but significantly reduced milk transfer and nutritive sucking in CG. What is Known: • Mothers report that nipple shields reduce nipple pain and enable continued Breastfeeding. • Concerns that nipple shield use may reduce milk transfer and alter infant sucking patterns are based on limited published evidence. What is New: • Nipple shield use is associated with a 25% reduction in pain scores in Breastfeeding mothers with chronic nipple pain. • Milk transfer is not reduced in dyads that regularly use a shield for chronic nipple pain. • Intra-oral vacuums are not impacted by nipple shield use in mothers experiencing pain.

  • effect of nipple shield use on milk removal a mechanistic study
    BMC Pregnancy and Childbirth, 2020
    Co-Authors: Viviane Silva Coentro, Sharon L Perrella, Ching Tat Lai, Alethea Rea, Kevin Murray, Donna T. Geddes
    Abstract:

    Concerns about reduced milk transfer with nipple shield (NS) use are based on evidence from studies with methodological flaws. Milk removal during Breastfeeding can be impacted by infant and maternal factors other than NS use. The aim of this study was to control electric breast pump vacuum strength, pattern and duration across multiple study sessions to determine if NS use reduces milk removal from the breast. A within-subject study with two groups of Breastfeeding mothers (infants < 6 months) were recruited; Control Group (CG): no Breastfeeding Difficulties; Pain Group (PG) used NS for persistent nipple pain. Mothers completed three randomised 15 min pumping sessions using the Symphony vacuum curve (Medela AG); no NS, fitted NS, and a small NS. Sessions were considered valid where the applied vacuum was within 20 mmHg of the set vacuum. Milk removal was considered as pumped milk volume, and also percentage of available milk removed (PAMR), which is calculated as the pumped volume divided by the estimated milk volume stored in the breast immediately prior to pumping. Of 62 sessions (all: n = 31 paired sessions) a total of 11 paired sessions from both PG (n = 03) and CG (n = 08) were valid (subset) with and without a fitted NS. Only 2 small shield sessions were valid and so all small shield measurements were excluded. Both pumped volumes and PAMR were significantly lower with NS use for all data but not for subset data. (All: Volume and PAMR median: no NS: 76.5 mL, 69%, Fitted NS: 32.1 mL, 41% respectively (volume p = 0.002, PAMR p = 0.002); Subset: Volume and PAMR median: no NS: 83.8 mL, 72%; Fitted NS: 35.2 mL, 40% (volume p = 0.111 and PAMR p = 0.045). The difference in PAMR, but not volume, was statistically significant when analysed by linear mixed modelling. A decrease of 10 mmHg was associated with a 4.4% increase in PAMR (p = 0.017). This experimental data suggests that nipple shield use may reduce milk removal. Close clinical monitoring of Breastfeeding mothers using nipple shields is warranted.