Pump up the music: Improving breast milk production in the NICU

The breast pump is a fabulous invention. It is what gives modern moms the option to pursue a career and breastfeed. And for moms of babies born prematurely, it is everything. Their babies get a great start with breast milk, and moms can establish milk supply even if they are separated by prolonged stays in the NICU.

Source: Wikimedia Commons

In a study published in Advances in Neonatal Care last week, Douglas Keith and colleagues reported on their attempt to increase production in moms pumping milk for their preemie babies [2]. 162 moms of preemie (average 32 weeks) or critically ill newborns admitted to the NICU were given a hospital-grade breast pump and encouraged to pump 8 times per day. They were randomly assigned to one of 4 groups. A control group received standard support for breastfeeding, and the remaining 3 groups were given a recording to listen to during pumping. The second group received a recording with a spoken guided relaxation. The third received the same guided relaxation, but it was accompanied by soothing guitar lullabies. The fourth received the relaxation/guitar recording, plus a video player with images of their own babies. Milk production and milk fat content were measured over 14 days.

What effect did a little music and pictures have on milk production? The results were actually quite striking. All 3 of the “listening intervention” groups produced more milk during the study, and not just a little more – 2-3x more! Milk production on day 14 is shown below.

Listening to the guided relaxation increased milk production, and this effect was most striking when it was accompanied by music and baby pictures. In addition, milk fat content was higher in the verbal+music+pictures group, as well as for the first week in the verbal only group. Importantly, there was no difference in pumping frequency between the 4 groups of moms.

I think these results are remarkable. Presumably, the audio recordings and baby photos help mom to relax and improves milk letdown, though this study didn’t investigate specific mechanisms. Still, providing music and baby images is an easy and inexpensive intervention, and the data show that it can significantly improve milk production during the first few weeks of life in babies that likely need it most.

The authors speculate that perhaps the “listening interventions” relaxed mom and increased oxytocin release. Oxytocin is a favorite hormone of all mamas. Sometimes called the “love hormone” or “cuddle chemical,” oxytocin plays a critical role in the birth process, milk letdown during breastfeeding, pair bonding, and maybe even sexual pleasure. (This story on oxytocin and male sexual function caught my eye a couple of days ago. Plus, there’s this one and this one, too. The cuddle chemical makes for catchy science stories in the media.) Music therapy has been shown to reduce stress in other situations, but the effect of music on oxytocin is unexplored.

It is interesting to note that the moms in the verbal+music group didn’t seem to benefit as much as those listening to the spoken relaxation alone or those in the verbal+music+pictures group. The authors point out that music might have been more effective if moms were allowed to choose their own favorite tunes. Maybe the guitar lullabies were of the annoying variety, particularly for a mom listening on repeat for 8 pumping sessions per day. For that matter, I would imagine that any guided relaxation recording could suffer from the same problem. Since the study didn’t tease out the specific effects of music vs. spoken words, I think that moms wishing to apply this idea in their own lives should assume that any relaxing recording might do.

This paper suffered from some kooky stats and figures. For example, I honestly don’t know how the authors managed to publish this without error bars shown on their figures. Usually that’s a red flag that the study and/or the journal has some real problems (usually both). In this case, though, I thought the data were rather remarkable and worth sharing.

If you’re pumping – especially for a preemie – taking the time to get your warm fuzzies going is definitely worth a shot. Turn on some relaxing music and turn your gaze on your little one. Put your feet up, take some deep breaths, and know that in this case, kicking back might just be the best thing you can do for your baby.

Did you pump while your baby was in the NICU? Or to help establish your milk supply? Do you have any tips on pumping to help make it more enjoyable for other moms?

REFERENCES

1.  Hill, P.D., J.C. Aldag, R.T. Chatterton, and M. Zinaman. Comparison of milk output between mothers of preterm and term infants: the first 6 weeks after birth. J Hum Lact. 21(1): p. 22-30. 2005.

2.  Keith, D.R., B.S. Weaver, and R.L. Vogel. The effect of music-based listening interventions on the volume, fat content, and caloric content of breast milk-produced by mothers of premature and critically ill infants. Adv Neonatal Care. 12(2): p. 112-9. 2012.