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. 2025 Jun 1;25(3):270-282.
doi: 10.1097/ANC.0000000000001270. Epub 2025 May 20.

Measuring Postpartum Milk Production Following Antenatal Milk Expression in Mothers of Infants With Congenital Anomalies

Nina A Juntereal  1 , Ching T Lai, Donna T Geddes, Eileen T Lake, Diane L Spatz
Affiliations

Measuring Postpartum Milk Production Following Antenatal Milk Expression in Mothers of Infants With Congenital Anomalies

Nina A Juntereal et al. Adv Neonatal Care. .

Abstract

Background: Mothers of infants with congenital anomalies may experience challenges with milk production. Antenatal milk expression (AME) is thought to support milk production, as past research suggests it facilitates secretory activation. However, past research relied on self-reported data.

Purpose: This study examined secretory activation and coming to volume, 2 critical stages of postpartum milk production, by measurement of human milk biomarkers from days 1 to 7 and 24-hour milk volume from birth until day 14 in mothers of infants with congenital anomalies who practiced AME.

Methods: Women carrying infants with congenital anomalies received AME education, did AME, gave birth, and recorded their 24-hour pumping frequency and milk volume. An ion selective electrode (ISE) and laboratory analysis were used to measure human milk biomarkers.

Results: Sixteen mothers completed AME, and all infants were born at term. Most mothers (87.5%) had normal biomarkers at least once, but biomarkers did not stay in normal range. Four mothers (25%) experienced secretory activation within 72 hours after birth. The pumping frequency and 24-hour milk volume varied. Only 9 (56.25%) mothers secreted ≥500 mL of milk by day 14.

Implications for practice: AME may offer benefits, but secretory activation does not appear to be impacted. The ISE shows promise as a nursing-driven intervention to screen for potential milk volume concerns.

Implications for research: Further research is needed on AME and human milk biomarkers in this at-risk population.

Keywords: biomarkers; breastfeeding; congenital anomalies; ion-selective electrodes; lactation; lactose; postpartum period; sodium; “milk, human”.

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