Expressed breast milk feeding practices in Hong Kong Chinese women: A descriptive study

There is an increasing prevalence of breast milk expression and expressed breast milk feeding in healthy full-term infants. The purpose of this study was to provide up-to-date evidence on the practice of expressed breast milk feeding and to identify factors associated with expressed breast milk feeding in Hong Kong Chinese mothers of healthy full-term infants.

We used a prospective cohort study design to recruit 821 mothers who gave birth to healthy full-term infants in two public hospitals in Hong Kong. Participants completed self-administered baseline questionnaires during their postpartum stay and were followed-up by a series of telephone calls over a 6 months period or until they stopped breastfeeding, whichever came first. The proportion, mode, and type of infant feeding (direct breastfeeding, expressed breast milk feeding and infant formula feeding) were assessed at each telephone follow-up.

In our sample, 14.6%, 20.2% and 15% of the participants fed expressed breast milk only to their infants at 1.5, 3 and 6 months respectively. Less than one-half were giving only direct breastfeeding only at 1.5 and 3 months. Within the first six months postpartum, 84.6% of the participants had given expressed breast milk. More than 80% of participants obtained a breast pump before giving birth, with the majority obtaining electric pumps. The most common reason for expressing breast milk within the first 1.5 months postpartum was experiencing breastfeeding difficulties (35%). Returning to employment was the strongest predictor of expressed breast milk feeding at three months postpartum (adjusted odds ratio [aOR]=8.71, 95% Confidence interval [CI]= 5.12-14.8).

A high proportion of Hong Kong Chinese mothers of healthy, full-term infants pump and feed expressed breast milk at some point during the first 6 months postpartum. Participants purchase or obtain breast pumps before giving birth, often in anticipation of breastfeeding difficulties and returning to work.