Manual and pump methods of expression of breast milk

This study was designed to compare two methods of breast milk expression, namely, the manual and the pumping method using a hand-held cylindric pump. The parameters evaluated were (i) the output of breast milk during milk expression sessions of 15 minutes' duration, and, (ii) the subjective preference of the method by the mothers. In the first phase, 22 mothers whose infants were on gavage feeding in the nursery, had 3 sittings each by the two methods on 4th and 5th postnatal days (66 expression). It was seen that the use of breast pump (Medela) was associated with significantly higher volume of breast milk expressed per session (41.57 +/- 16.05 ml vs. 21.7 +/- 10.5 ml, P < 0.001). In the second phase, 14 mothers had such sessions (42 each) not only on the 4th and 5th postnatal days, but lso on days 8 and 9. It was again seen that, the volume of breast milk expressed was greater by the pump method than the manual expression (on day 5 and 6 (46.8 +/- 26.3 ml vs 31.2 +/- 15.5 ml, P < 0.01) as well as on day 8 and 9 (50.40 +/- 11.2 ml vs 38.49 +/- 13.4 ml, P < 0.01). Subjectively, the pump expression was preferred by the mothers on day 4 & 5, while the manual expression was the preference on days 8 & 9. The use of breast pump is more efficient than the manual system of expression of breast milk among mothers whose infants are not directly breast-fed. It is recommended that in case the mothers prefer to use the manual method, let them express as much milk as possible by this method initially, and then follow it up with a short period of pumping to ensure complete evacuation of breasts.