Online questionnaire sought parent input on challenges faced, priorities for research, opinions on ethical issues and dissemination pathways for results... closed after a week because there were so many responses... #ABM2022
675 respondents (!!), 47% very preterm, 24% early preterm, 51% had provided breastmilk for at least six months, 23% for more than a year... 95% white ethnicity #ABM2022
[Challenge of online data collection - individuals who have been made marginalized may have lived experiences that diminish trust in healthcare, and therefore online surveys... ] #ABM2022
Questions about expressing... resonates w/ my clinical experience - "realistic" is very real consideration... #ABM2022
Additional questions about logistics and lactating parent experience of expression... "How to feel happier about expressing" #ABM2022
Personalized feedback desired - can we predict volume / outcome based on early trajectory? #ABM2022
Moving on to at-breast feeding - lots of questions about transitioning... what to do when breast is bigger then baby's mouth... #ABM2022
Questions about nipple shields - most participants had had good experiences w/ nipple shield, but were told to stop... #ABM2022
And what does success mean? [so cool to hear this talk on the heels of our #ROSEABM22 meeting!] Nature of breastmilk feeding experience, and duration of breastmilk feeding... No consensus on what duration is "success" #ABM2022
Parental concerns about research:
- imposing pressure to express
- increasing feelings of judgement / inadequacy
- extra burden at a stressful time #ABM2022
Key theme: burden / mental health impact of expressing for preterm infant... we have A LOT of work to do to support mothers of medically fragile infants!! #ABM2022
Take aways:
- milk yield is important
- any / exclusive breastmilk feeding alone does not capture enough - consider more nuanced assessment - parent's goals, satisfaction, mental health
- direct bfing is important
- long term bfing is important #ABM2022
@ilana_abc notes that those with less privilege are less seen and heard in research studies... importance of an equity-centered process for patient engagement studies... #ABM2022
.@ilana_abc: Optimal PPI (patient-public involvement) is collaboration - this model was a consultation, but did not share power. Looks forward to moving to full collaboration for future work #ABM2022
How to counter the view that at-breast feeding is "too tiring" for baby? @ilana_abc: what's our priority? Is this about getting the baby home 2 days sooner? Or about supporting long-term #breastfeeding?
• • •
Missing some Tweet in this thread? You can try to
force a refresh
Last talk of the day: Prolactin: Pleiotropic actions in pregnancy and lactation #ABM2022
Prolactin's role:
- Required for milk production
- Acts on secretory epithelial cells to promote synthesis of milk proteins
- Mammary gland development during pregnancy #ABM2022
Prolactin secretion outside of lactation:
- Dopamine inhibits prolactin secretion
- Prolactin stimulates dopamine release
- Low basal prolactin levels, with some variation in menstrual cycle #ABM2022
Next up: Panel Discussion: Skin-to-Skin Around the World #ABM2022, starting with Maite Hernandez-Aquilar
Context: skin-to-skin was not always recommended. Research in the early 1970s included initial contact, followed by 9 hours (!!) of separation... #ABM2022
Based on evidence, skin-to-skin should be standard practice... #ABM2022