FLOW AND COMPOSITION DETERMINATION OF SUCKLED BREAST MILK: 88

Abstract

Although human milk has been studied extensively, this milk has usually been collected unphysiologically by mechanical expression of the breast. Expressed breast milk (EBM) may differ from sucked breast milk (SBM), the milk that the infants obtain during breast feeding. The calculation of SBM content requires simultaneous measurement of milk flow and composition throughout suckling since these two variables change continuously during a feed. We have weighed 132 six day old infants at different times during feeding on each breast (each infant contributing only one weighing datum) and using cross sectional data analysis we have demonstrated that the breast has an exponential emptying pattern with a mean of 50% and 85% of the feed from each breast flowing from mother to infant after two and four minutes respectively. Preliminary data indicate that this same flow pattern occurs during a feed at one month after delivery. We describe how a nipple shield, equipped to sample milk continuously during feeding can be used to calculate the nutrient content of SBM by matching flow with composition data. We also describe a micro-miniaturised ultrasonic flowmeter incorporated into a nipple shield that measures milk flow throughout feeding. Our studies are of relevance to the accurate determination of infants' nutritional requirements in this country and in the developing world.

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