Cutaneous perfusion of the human lactating breast: a pilot study with laser Doppler perfusion monitoring

Knowledge on the hemodynamics of the human lactating breast contributes to our understanding of lactation physiology, as well as the development and management of breastfeeding problems. The objective of this pilot study was to investigate whether laser Doppler perfusion monitoring (LDPM) can be employed to measure physiological changes in mammary cutaneous perfusion during milk extraction. 
 <i>Approach</i>: We evaluated mammary cutaneous perfusion with LDPM in 9 lactating women during milk extraction in both the ipsilateral ('milk extracting') and contralateral ('passive') breast. Fourier domain filtering of the LDPM signal was applied to correct for the influence of the periodic tissue movement caused by the breast pump.
 <i>Main results</i>: Cutaneous perfusion increased temporary during 32.2 ± 15.6 seconds with 16–74% for all women who sensed their milk ejection reflex (n = 6) in both the ipsilateral and contralateral breast. For those women who did not sense a milk ejection reflex (n = 3), the changes in cutaneous perfusion were less outspoken (maximally 25%). 
 <i>Significance</i>: This pilot study demonstrates that LDPM is a promising method for the further investigation of physiological changes in mammary cutaneous perfusion during milk ejection. Objective feedback on the occurrence and progression of milk ejection can support lactation research in general, maternal breastfeeding confidence, and may be an early indicator for the development of breastfeeding problems.