Preterm birth, steroid treatment delay lactation

NEW YORK (Reuters Health) - Mothers who give birth prematurely may find their milk is slow coming in after delivery. This is especially likely when they have been given corticosteroids before the birth in an attempt to improve infant outcomes, new research shows.

"In view of the advantages of mothers' own milk, additional support with lactation is recommended for mothers of preterm infants, particularly those who have been treated with corticosteroids before the delivery," Dr. Jennifer J. Henderson and colleagues conclude in a report in the medical journal Pediatrics.

Henderson, from the University of Western Australia in Crawley, and others examined how premature birth and antenatal steroid treatment affected lactogenesis II, the point after birth when copious milk secretion begins. The 50 mothers in the study measured the volume of milk expressed in 24-hour periods for 10 days after delivery.

The average gestational age at delivery was 31 weeks, and the investigators found that the volume of breast milk obtained was directly related to the gestational age.

In mothers with infants between 28 and 34 weeks' gestational age, milk volumes were significantly reduced when delivery occurred 3 to 9 days after steroid treatment compared with delivery 0 to 2 days after treatment.

The results support previous research showing milk volumes rise as gestational age increases, the researchers conclude. In addition, they note, "this study is the first to show a potential small effect of a single course of antenatal corticosteroids on lactogenesis II."

SOURCE: Pediatrics, January 2008.