Exclusively Pumping Women's Milk Production and Pumping and Feeding Dynamics-An Online Survey

Background/Objectives: Women who exclusively pump (EP) expend more time and effort on pumping and feeding infants their expressed breast milk (EBM) than those who directly breastfeed. However, little is known about their 24 h milk production (MP) or pumping and feeding dynamics. Methods: An online survey of 195 EP women explored the experiences, characteristics, MP and pumping and feeding dynamics of EP women. Quantitative data were compared by prematurity/neonatal unit admission, milk supply and parity, and self-reported MP was compared with MP in a predominantly breastfeeding reference group. Results: The 24 h pumping frequency was 6.0 [5.0, 8.0] with a pumping session duration of 25 [20, 30] min and a total pumping time of 2.3 [1.8, 3.0] h/24 h. The self-reported MP was 900 [600, 1100] mL/24 h, which was higher than that of the reference group (p = 0.012). Infant cues (58%), as well as advice from the child health nurse (39%), lactation consultant (34%) and pediatrician (34%) informed EBM feed volumes. Fifty-six percent of the infants were fed on demand, with 37% using a feeding schedule. Infants were fed 7.0 [6.0, 8.0] times/24 h; the average individual EBM feed and total 24 h volume were 120 [100, 150] and 750 [600, 900] mL, respectively. Conclusions: This study confirms it is possible to sustain lactation with EP and provide sufficient EBM volumes for the infant. However, the time commitment of EP and infant feeding represents a serious burden. These families would benefit from enhanced professional support and accessible evidence-based pumping and feeding guidelines.