Alison Stuebe Profile picture
Sep 16 23 tweets 12 min read
Next up: Ilana Levine on parents’ research priorities for lactation after prematurity #abm2022 Image
Lots of challenges unique to lactation after prematurity - and extra importance for medically fragile infants #ABM2022 Image
Parents invited to co-design intervention for ongoing trial #ABM2022 npeu.ox.ac.uk/express Image
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 Image
Additional questions about logistics and lactating parent experience of expression... "How to feel happier about expressing" #ABM2022 Image
Personalized feedback desired - can we predict volume / outcome based on early trajectory? #ABM2022 Image
Storage, pumping routine... #ABM2022 Image
Moving on to at-breast feeding - lots of questions about transitioning... what to do when breast is bigger then baby's mouth... #ABM2022 Image
Questions about nipple shields - most participants had had good experiences w/ nipple shield, but were told to stop... #ABM2022 Image
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 ImageImage
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 Image
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
So much resonance with #ROSEABM2022 ! #ABM2022 Image
We have lots of opportunities to #MakeBreastfeedingEasier @ilana_abc #ABM2022 Image
The research team has created posters to share in NICUs about their parent findings #ABM2022 npeu.ox.ac.uk/express/engage Image
Read more about the parent involvement in planning to study here: #ABM2022 …reastfeedingjournal.biomedcentral.com/articles/10.11…
@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?

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More from @astuebe

Sep 16
Last talk of the day: Prolactin: Pleiotropic actions in pregnancy and lactation #ABM2022 Image
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 Image
Read 19 tweets
Sep 16
Next session: Yvonne LeFort on Ankyloglossia & the breastfeeding dyad #ABM2022 Image
Lots to cover in 45 minutes... #ABM2022 Image
Context: many factors impact effective and comfortable breastfeeding - not just the frenulum... #ABM2022 Image
Read 27 tweets
Sep 16
Next up: Panel Discussion: Skin-to-Skin Around the World #ABM2022, starting with Maite Hernandez-Aquilar Image
Context: skin-to-skin was not always recommended. Research in the early 1970s included initial contact, followed by 9 hours (!!) of separation... #ABM2022 ImageImage
Based on evidence, skin-to-skin should be standard practice... #ABM2022 Image
Read 28 tweets
Sep 16
Podium presentations starting now... #ABM2022 First up: #breastfeeding disparities and #SUID Image
Study included 4 years of births in US and linked SUID deaths #ABM2022
liebertpub.com/doi/10.1089/bf… Image
Mediation analysis estimated the extent to which breastfeeding disparities explained differences in SUID rates #ABM2022 Image
Read 21 tweets
Sep 16
Workshop getting started at #ABM2022... Reducing Racial Disparities in Breastfeeding in the USA Image
Dr. Michal Young kicking off the conversation #ABM2022 Image
Young: The human race began in Africa - and if these African women had not breastfed, none of us would be here today... #ABM2022 Image
Read 21 tweets
Sep 16
Kicking off the conference: Larry Noble on Breastfeeding, Microbiome and Epigenetics #ABM2022
Breastfeeding occurs in the 1,000 Days, a critical window that impacts lifelong health ncbi.nlm.nih.gov/pmc/articles/P… #ABM2022 Image
This early critical window impacts lifelong development of the microbiome ncbi.nlm.nih.gov/pmc/articles/P… #ABM2022 Image
Read 19 tweets

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