Comparing the effect of a lactation-specific relaxation and visualisation intervention versus standard care on lactation and mental health outcomes in mothers of very premature infants (the EXPRESS trial): study protocol for a multi-centre, unmasked, randomised, parallel-group trial

Background Premature birth is the leading cause of neonatal death and can cause major morbidity. Maximising the amount of maternal breastmilk given to very premature infants is important to improve outcomes, but this can be challenging for parents. Parents of infants receiving neonatal care also hav...

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Bibliographic Details
Published in:Current controlled trials in cardiovascular medicine 2022-07, Vol.23 (1), p.611-611, Article 611
Main Authors: Levene, Ilana, Bell, Jennifer L, Cole, Christina, Stanbury, Kayleigh, O'Brien, Frances, Fewtrell, Mary, Quigley, Maria A
Format: Article
Language:English
Subjects:
Anxiety
Breast feeding
Breast milk
Breastfeeding
Breastfeeding & lactation
Breasts
Care and treatment
Comparative analysis
Data collection
Health aspects
Health care
Hormones
Infants
Infants (Premature)
Intervention
Maternal stress
Meditation
Menstruation
Mental health
Methods
Mothers
Newborn
Newborn babies
Patient outcomes
Post traumatic stress disorder
Premature babies
Premature birth
Preterm
Psychological aspects
Questionnaires
Relaxation
Stress
Study Protocol
Visualization (Mental images)
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Summary:Background Premature birth is the leading cause of neonatal death and can cause major morbidity. Maximising the amount of maternal breastmilk given to very premature infants is important to improve outcomes, but this can be challenging for parents. Parents of infants receiving neonatal care also have high rates of anxiety and distress. There is growing evidence for the impact of maternal relaxation interventions on lactation, as well as mental health. The trial will assess whether a brief self-directed relaxation and visualisation intervention, recommended for use several times a day during expression of milk, improves lactation and mental health outcomes for mothers of very premature infants. Methods Multi-centre, randomised, controlled, unmasked, parallel-group trial with planned 132 participants who have experienced premature birth between 23 weeks and 31 weeks and 6 days of gestation and plan to express milk for at least 14 days. The primary outcome is the highest 24-h expressed milk yield recorded on any of day 4, day 14 or day 21 after birth. Secondary outcomes include exclusive breastmilk feeding at 36 weeks post-menstrual age and at 4 months after the estimated date of delivery, Spielberger State Trait Anxiety Index at day 21 and Post-traumatic stress Check List (for DSM 5) at day 21. Discussion Breastmilk feeding for premature infants is an important research priority, but there are few randomised controlled trials assessing interventions to help parents reach lactation goals in this challenging context. This trial will assess whether a no cost, easily scalable relaxation tool has a role in this setting. Given the lack of harm and potential for immediate dissemination, even a small benefit could have an important global impact. Trial registration ISRCTN16356650. Date assigned: 19/04/2021. Keywords: Newborn, Preterm, Breastfeeding, Breast milk, Maternal stress, Meditation, Relaxation therapy
ISSN:1745-6215
1745-6215
DOI:10.1186/s13063-022-06570-9