Methods of milk expression for lactating women

Area of Science:

• Reproductive Health
• Infant Nutrition
• Evidence-Based Midwifery

Background:

• Breastfeeding is crucial for infant health, but not all infants can feed directly at the breast.
• Evaluating various methods for expressing breast milk is essential for supporting mothers and infants.
• This review updates previous findings on milk expression techniques.

Purpose of the Study:

• To assess the acceptability, effectiveness, safety, and cost of different milk expression methods.
• To evaluate the impact of expression methods on milk composition and contamination.
• To compare various milk expression techniques, including manual, electric, and relaxation-assisted methods.

Main Methods:

• Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
• Searched multiple databases including Cochrane Pregnancy and Childbirth Group's Trials Register and CINAHL.
• Independent assessment of trials, data extraction, and risk of bias analysis by three authors.

Main Results:

• Relaxation techniques significantly increased milk volume compared to no intervention (MD 34.70 ml).
• Hand expression showed lower milk volume over six days compared to electric pumps (SMD -1.00 ml), though results varied.
• No significant differences found in volume between simultaneous/sequential pumping or manual/electric pumps; hand-expressed milk had higher sodium and lower potassium concentrations in one study.

Conclusions:

• The optimal milk expression method depends on individual mother-infant factors and the purpose of expression.
• Low-cost interventions like relaxation and hand expression can be effective alternatives to large electric pumps.
• Caution is advised due to small sample sizes, study diversity, and variability in results.