Mothers’ Reasons for and Perceptions of Human Milk Expression and Feeding: A longitudinal, qualitative investigation

Abstract

A majority of breastfeeding women in the U.S. use human milk expression (HME), or pumping, to feed human milk (HM) to their babies. Yet, little is known about the reasons and strategies for HME, mothers’ perceptions of HME, and how HME fits with HM feeding and other feeding choices. We used qualitative methods to explore these issues. We recruited 20 socio‐demographically diverse pregnant women who were planning to breastfeed and considering HME. We conducted in‐depth, semi‐structured qualitative interviews in late pregnancy, early postpartum, and at other times in the first year. Interviews were transcribed and themes were identified with content analysis. Mothers used HME for several reasons, such as difficulty feeding at the breast, to allow HM feeding while at work, to facilitate bonding with family members, and to maintain or increase milk supply. Mothers perceived pumps to be less efficient than infants at emptying breasts, and HME as time‐consuming, costly, and unpleasant, but necessary to meet HM feeding goals. Bottled HM was used as an occasional stand‐in for feeding at the breast or as a major method of HM feeding. Bottled HM was rarely fed by mothers themselves. The reasons and strategies for HME and the feeding of bottled HM vary and may influence how “breastfeeding” is conducted. Given the importance of breastfeeding, these phenomena must be further explored. Funded by NIH (T32DK007158) and USDA (Hatch 399449).