Early Expressed Milk Volume and Coming to Volume for Mother's Own Milk in Hospitalized Infants

Early pumping frequency is strongly correlated with achieving coming to volume (CTV) and having increased milk volume production. A model was created to predict CTV using early pumping frequency, achievement of early morning pumping, and birth weight.

To assess if cumulative pumping volumes during the first 5 postnatal days (CV x 5) influence coming to volume (CTV: producing > 500 milliliters breast milk per day by postnatal Day 14) for mothers of hospitalized infants, with a secondary aim to develop and compare a new predictive model using CV x 5 with our previous model.

A retrospective cohort analysis was conducted at a tertiary center for singleton mother-baby dyads of neonatal intensive care infants between January 2020 and December 2023.

Of 887 mother-baby dyads, 325 (37%) achieved CTV and were more likely to have higher CV x 5 (1,058 ± 25 ml vs. 231 ± 19 ml; p < 0.0001). In generalized regression models for CTV that included birth weight, five or more milk-producing pumping episodes on postnatal Day 5 (5 x 5), pumping at least once between 1 am and 5 am by postnatal Day 5 (AM x 5), and CV x 5, only CV x 5 and 5 x 5 remained significant (p < 0.0001).

Pumping frequencies and accumulating pumped volumes in the first 5 postnatal days are important factors in predicting mothers' likelihood of CTV. CTV is significantly associated with CV x 5, and, with 5 x 5, creates a stronger model than that of 5 x 5 and higher birthweight. This new model may help identify mothers needing additional support to achieve CTV as early as postnatal Day 5.