Methods of milk expression for lactating women

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Lactation Science

Background:

• Breastfeeding is crucial, but not all infants can feed directly.
• Alternative methods for milk expression require thorough evaluation.

Purpose of the Study:

• To assess the acceptability, effectiveness, safety, milk composition, contamination, and costs of various milk expression methods.
• To compare different breast milk expression techniques, including hand expression and various pumps.

Main Methods:

• Conducted a systematic review of randomized and quasi-randomized trials.
• Searched multiple databases and contacted experts for relevant studies.
• Included 41 trials involving 2293 participants, comparing pumps, hand expression, and adjunct behaviors.

Main Results:

• No significant differences in milk contamination or nipple pain were found between pumps and hand expression.
• Interventions like relaxation, massage, and increased pumping frequency increased milk volume.
• Hand expression or large electric pumps yielded higher protein content; hand expression showed higher sodium and lower potassium.

Conclusions:

• The optimal milk expression method depends on individual mother-infant factors and the purpose of expression.
• Low-cost methods like hand expression, relaxation, and massage may be as or more effective than large electric pumps for certain outcomes.
• Further independently funded research is needed for non-commercially viable techniques like hand expression and relaxation.