Effects of newborn intraoral pressure on colostrum intake

ZHANG, Feng; BAI, Ting; WU, Fan

doi:10.1590/1678-9865202134e200195

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ORIGINAL • Rev Nutr 34 • 2021 • https://doi.org/10.1590/1678-9865202134e200195 linkcopy

Effects of newborn intraoral pressure on colostrum intake

Efeito da pressão intraoral de recém-nascidos na ingestão de colostro

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective To explore the effects of intraoral pressure on colostrum intake.

Methods Healthy women with full-term infants were admitted in the study after birth. Intraoral pressure was detected before and after the mothers’ onset of lactation by a pressure sensor during a breastfeeding session. Colostrum intake was measured by weighting the infant before and after breastfeeding. The onset of lactation was confirmed by the mothers’ perceptions of sudden breast fullness.

Results The newborns’ peak sucking pressure was 19.89±7.67kPa before the onset of lactation, dropping to 11.54±4.49kPa after mothers’ onset of lactation (p<0.01). The colostrum intake was 4.02±4.26g before the onset of lactation, and 11.09±9.43g after the onset of lactation. Sucking pressure was correlated with the amount of colostrum intake before and after the onset of lactation after adjusting the confounding factors.

Conclusions The newborns’ intraoral pressure at early stage played a predominant role in colostrum intake. It is recommended to initiate breastfeeding immediately after the birth to take advantages of the active and robust sucking response. It is valuable to understand the importance that the sucking pressure plays in the colostrum intake and active immunity achievement during the first several days after birth.

Keywords
Colostrum; Lactation; Newborn; Suction

Variables	Peak sucking pressure		Mean sucking pressure		Baseline sucking pressure
Variables	Mean	SD	Median	IQR	Median	IQR
Before onset of lactation	19.89	7.67	9.55	6.90	2.10	1.20
After onset of lactation	11.53	4.49	6.00	4.60	1.30	1.10
t/Z	16.40*		-3.00**		-1.37**
p	<0.01		<0.01		0.17

Variables		Colostrum Intake
Variables		r	p
Before onset of lactation
	Peak sucking pressure BOL	0.47*	<0.01
	Mean sucking pressure BOL	0.36**	0.04
	Baseline sucking pressure BOL	0.37**	0.03
After onset of lactation
	Peak sucking pressure AOL	0.54*	<0.01
	Mean sucking pressure AOL	0.40**	0.03
	Baseline sucking pressure AOL	0.47**	<0.01

Variables		Descriptives of each variable			Colostrum Intake BOL		Colostrum Intake AOL
Variables		Mean±SD	Mean (IQR)	N (%)	X²/t	p	χ²/t	p
Maternal age (years)		25.91±1.85			-0.53	0.19	-2.07	0.48
Race					0.62	0.54	0.38	0.71
	Han			33 (97.06)
	Minority			1 (2.94)
Residence					0.13	0.89	1.65	0.11
	Native			26 (76.47)
	Immigrant			8 (23.53
Household income (10,000CNY/per year)		8.00±4.04			-0.20	0.84	-0.78	0.44
Maternal education(year)					0.69	0.49	-1.13	0.27
	<9			3 (8.82)
	9-11			3 (8.82)
	11-15			25 (73.54)
	>15			3 (8.82)
Employment status					0.35	0.73	-0.38	0.70
	Employed			14 (41.18)
	Unemployed			20 (59.82)
Marriage
	Unmarried			0 (0)
	Married			34 (100)
Frequencies of antenatal care		9.97±1.27			-1.00	0.33	-1.23	0.23
Pre-gestational BMI(kg/m²)		20.18±2.16			-2.61	0.01	0.40	0.69
Gestational BMI gain (kg/m²)		5.36±1.40			0.72	0.48	0.81	0.42
Gestational age (week)		39.64±1.51			-0.72	0.48	1.39	0.17
Birth weight (g)		3,292.65±304.30			0.46	0.65	0.85	0.40
Newborn gender					-0.70	0.49	-2.43	0.02
	Male			13(38.24)
	Female			21(61.76)
Time of first breastfeeding (min)			37.00 (29.00)		-1.22	0.23	-1.31	0.20
Time of first breastfeeding (min)			10.00 (15.00)		-0.19	0.85	0.23	0.82
Breastfeeding frequency (times/24h)		8.81±1.50			1.51	0.14	2.20	0.04
Sucking duration (min/24h)		180.61±71.32			2.08	0.45	2.16	0.04
Frequency of giving formula (times/24h)		2.91±1.86			-1.33	0.19	-0.42	0.68
Volume of formula within (ml/24h)		58.19±43.46			-0.74	0.46	-0.58	0.57
Pacifier usage					0.90	0.38	0.48	0.63
	Yes			22 (64.71)
	No			12 (35.29)
IBAT		10.73±2.25			1.74	0.09	2.23	0.03
EPDS		4.74±2.62			0.30	0.77	1.17	0.25
Episiotomy					0.58	0.56	0.98	0.33
	Yes			18 (52.94)
	No			16 (47.06)
Duration of Labor (h)		7.78±2.89			0.24	0.81	1.27	0.21
Oxytocin during labor					1.38	0.18	1.28	0.21
	Yes			12 (35.29)
	No			22 (64.71)

Factors of Colostrum intake BOL
	Coef.	t	p	95%CI
Peak sucking pressure BOL	0.24	2.99	<0.01	0.08	0.40
Pre-gestational BMI	-0.74	-2.59	0.01	-1.31	-0.16
F=8.71 p=0.00 R²=0.36 Adjust R²=0.32
Factors of Colostrum intake AOL
	Coef.	t	p	95%CI
Peak sucking pressure AOL	0.78	2.52	0.02	0.14	1.42
IBAT scores	1.56	2.31	0.03	0.17	2.95
Newborn gender	-8.78	-3.19	<0.01	-14.45	-3.13
F=9.58 p=0.00 R²=0.53 Adjust R²=0.47

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[1] Note: n=34;

[TFN01] ^*
Paired t test was conducted;

[TFN02] ^**
Wilcoxon test was conducted. Three infants had incomplete data; IQR: Interquartile Range.