Breastfeeding is full of challenges and trials. Each breastfeeding experience is different, even in subsequent attempts by the same mother. In some cases, poor suction or difficulty in latching on can occur, causing extreme difficulty in making sure that the infant gets enough milk. Poor feeding is especially common in premature infants.
Rather than give up the good fight right away, many mothers faced with this issue turn to expressing milk by either breast pump or hand expression. This can ensure that the infant is getting enough milk while still allowing them to receive the many benefits of breast milk. And, while originally, there was no real preference except for the mother’s, a new study indicates that, to increase continuation of nursing, hand expression should be the method of choice.
The new study, led by researchers at UCSF, monitored 68 mothers and healthy term infants that had difficulty feeding within 12 to 36 hours. Mothers were separated into two groups randomly. Each group was instructed to express milk for 15 minutes – one group by hand expression, the other by electric pump. Full instructions in expression were provided to each group.
Three questionnaires were given to each mother. Maternal pain, confidence in nursing, and overall experience were all evaluated in the questionnaires. Each group was then encouraged to continue expressing at home. They were not, however, required to continue.
Evaluations took place over the phone at one week, one month, and two months. Final evaluation included evaluation of milk transfer, breastfeeding confidence, maternal pain, expression experience, and breastfeeding rates at two months of age.
Milk transfer, breastfeeding confidence, maternal pain and expression experience was not much different between the two groups and infants all gained around the same weight. However, the evaluation of breastfeeding rates were much higher in mothers that hand expressed than those that used a breast pump.
“Until now, we didn’t know which technique was preferable in the early postpartum period. This study provides the first evidence in favor of hand expression,” said lead author Valerie Flaherman, MD, MPH, an assistant professor of pediatrics at UCSF and pediatrician at UCSF Benioff Children’s Hospital. “Based on our findings, clinicians should consider recommending hand expression to new moms whose babies are feeding poorly.”
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