Modification of a breast pump suction pattern increases milk yield during the first 4 days postpartum

This prospective study aimed to assess if the addition of 5 min nutritive suction cycles, following 15 min of predominantly non-nutritive suction cycles used to initiate breastfeeding, would result in an increase in milk yield during an expression session in the first 4 days postpartum.

A prospective interventional study was conducted in the Netherlands, enrolling 90 breastfeeding patients who delivered at ≥36 weeks gestation and had infants aged ≤96 h old with a clinical indication to express milk using a breast pump. One of the participants' clinically indicated pumping sessions was used for a 20-min breast expression assessment. The session comprised 15 min of predominantly non-nutritive standard suction followed by 5 min of nutritive suction using a hospital-grade electric breast pump. The primary outcome measured the difference in milk volume between 15- and 20-min pumping in total and per postpartum day in the first 4 days postpartum. Secondary outcomes included expression volume at 15 and 20 min pumping per patient characteristic and milk yielded milliliters per minute.

The primary outcome measure of the difference in milk volume between 15- and 20-min pumping was significantly increased both overall (1.39 vs. 2.83 mL, p < 0.001) and per postpartum day (p < 0.001). Milk yield per minute was significantly lower during the initial 15 min compared to the additional 5 minutes pumping (0.09 vs. 0.29 mL/min, p < 0.001).

This study demonstrates a significant incremental improvement in milk removed during pumping episodes conducted in the first 4 days postpartum by the implementation of a 5 minute additional nutritive suction pattern to a 15 min predominantly non-nutritive suction cycle pattern. These findings could play a crucial role in supporting early access to colostrum and improving long-term breastfeeding outcomes.